I’ve always had a heart that behaves a bit oddly. I had a couple of Holter monitors to see why. But nada. They offered but did not recommend an invasive and yucky test; the results would get me nowhere as the test was still in the research realm. So we left things as they were.
Then I had a closed head injury, a kind of traumatic brain injury where the brain bounces back and forth inside the skull. My heart rate shot up permanently. And three years later, I had a Holter monitor done.
So you’re probably wondering what a Holter is. Patience! I’ll explain in a mo.
Unlike the previous ones, we discussed the results over a quick phone call because of SARS barring me from the hospital. I don’t remember the specifics except nothing changed.
Then four years later, another doctor noticed my fast pulse, put me on atenolol (a beta blocker), and a few days later I saw the cardiologist who ordered another Holter. (I had made an appointment to see him the previous Fall because my GP was not happy with my heart, so the timing was a bit of a coincidence.) He said don’t come off the drug for the test, and afterwards said, “just stressed” (no kidding!). Stay on the drug.
When my parents started to worry about my heart (like, they don’t worry about my health to my face, like, ever), I made an effort to find a new cardiologist. Did you know there are different specialties within the heart area? Me neither. Three docs and a Holter (on drug for that one too) later, I ended up with one who specializes in nerves to do with the heart. Yes! Finally the docs know what I know: the problem begins in the brain.
I have a sluggish vagus nerve. See a behavioural cardiologist. And change the beta blocker to one that includes an alpha blocker he said. But I never switched. He doesn’t prescribe; my GP was sick; my new GP had bigger fish to fry with me and told me just to stay on the atenolol. Alpha blocking by the new drug may be better in targetting the heart not blood pressure, but it fatigues as much as beta blocking. The atenolol was bad enough.
Life continued until the day my fore-feet turned blue and I stopped the atenolol. Holter time. Again. But this time, brain’s improved and I’m medication free.
So to a new place I go, a private lab this time. No hospital zoo with curtains for privacy; it’s quiet with private rooms. After many years of tests and physios/acupuncture, I know how to dress for these things so the tech and I aren’t endlessly waiting for me to reveal the relevant parts of my chest. I stand where ordered, and she wipes top and bottom of my chest clean. Twice. If you’ve never had this done, let me say the first step is OK, the second is like having a cat with a particularly rough tongue lick your very clean, dry, not moisturized skin. That done, complete with ouches and grimaces on my part, sorries on hers, she sticks on several electrodes swiftly, snaps wires onto them, and plugs the wires into a box connected to a computer. Several ECG recordings pop up on the computer monitor as does my heart rate in big red numerals: 125. So OK, I’m a little nervous. My left neck has been paining me on and off with the sunny, high-pressure system that has moved in over Toronto, and I know the increased pain that’s coming. Plus, yeah, OK, what will the docs find, is also in my mind.
Anywhoo, she checks the readings, returns to me, unplugs the wires from the box, whips off some of the electrodes, and leaves five in place. She proceeds to tape me up. You think having electrodes stuck on is bad enough — well, the tape ups the stuck-on-for-life factor. Two to three pieces of tape go over each electrode and the top part of the wire coming off it. She then plugs the wires into the Holter monitor’s wire. The monitor’s wire is long, thick, and grey. This monitor is rectangular on the side; the others I’ve had are rectangular on the vertical. This one shows the time in a thin window. I should’ve gotten a pocket torch (flashlight) to read the time. She placed the Holter in a black fabric case, with just the time showing, slipped a strap through the back of the case, and belted it around me. Phew. Previous Holters had been put in a purse-like case I had to carry over my left shoulder. They’re built like a physics textbook shrunk into a small purse-sized metal box, so you can imagine the weight and how relieved my neck is.
Handing me a folded piece of paper, she instructs me to write down the time — as taken from the Holter (which is two to three minutes off from the right time), not my clock — of what I was doing and the symptom when I feel anything. Also I am to note the times I exercise. I decided to add on the times I do my audiovisual entrainment and cranioelectrical stimulation sessions too. I can see them now, scratching their heads, going wha–? when reading those diary entries. Then dismissing them because that’s what usually happens: my symptoms and activities seem to have nothing to do with my heart, other than the rate rises quicker than usual when I begin exercising.
So they’ll find the usual SVTs (supraventricular beats, aka sudden zipping along of my heart rate), tachycardia (fast pulse, north of 130-140), bradycardia (slow pulse, south of 50), and my average will be…Well, that’s the rub. Hopefully, average will be in the 90s or less.
The whole visit took 11 minutes.
So I put up with the velcro-on-chest feeling for 24 hours, the wrestling with undoing the belt so I could go to sleep without the thing digging into my waist, the wires hanging down from under my shirt, the remembering to record diary entries, the velcro-on-chest irritation, the something-is-stuck-in-the-way feeling when I put my arms together in some of my exercises so I couldn’t do them properly, until it was time to leave the next day to return the dratted thing.
I didn’t rip off the electrodes. I began by peeling off the tape up to the electrode edges. Then, beginning at the loose edge of each electrode, if it had one, I pulled them off slowly, along with the tape. Some of the tape over one electrode overlapped with the tape over the next electrode. That was fun peeling off.
My skin looked OK, all identations and outlines. But tape glue remained in places, and my skin began screaming and turning red with pinpoints of blood. I really, really needed to put a pack of ice on it. But no time. The place was closing for the day soon, and I had to drop off the monitor else pay a $50 fine. So I slathered on my melaleuca-oil cream, dabbed on some more, and left.
I felt so liberated, so free, so light. Drop off took five seconds, and I was bouncing out the door, heading to a bookstore. This is my last time, I swear!
But as bad as a Holter is, 24-hour blood pressure monitoring is worse. Every two minutes, the cuff strapped round your non-dominant arm inflates, squeezing your muscles, taking your pressure. After 30 minutes, you’re ready to run screaming back to the lab to tell them to take it off now. They really should find better ways of measuring these things.