Thursday, August 6, 2015

Day 8.128 Name That Thing

No rhyme and no reason.

That I can deduce in comparing my notes, logs and files with the print-out.

Yesterday was my ten month check-up with the UW cardiology team. Data was downloaded from the pacer, an amazing technological function in and by itself, but staggeringly important when considering the facts.

The smaller than a mouse device not only samples and then corrects, the electronic nodal conductivity keeping my heart (yours does it automatically) beating in sinus rhythm, but records it as well.

You want a flash quiz to illustrate the robust complexity of all this?

The MEDTRONIC MVP pacemaker is set to keep my HR above 70bpm. Without it, Bradycardia and my preference for endurance sports training and racing, would send that rate plummeting down to the high 30's. That is an additional 40 beats per minute at metabolic rate. I have no limits on the top end, and have seen my max go from post-op 142 to 150 since returning to 'work'.

OK so here is the quiz:

Let use 70 as the metabolic number of beats and add an average of 100 (three hours yesterday were at 130), to get the daily beat count. I am going to guesstimate it at 90. That totals 2,160/day.

For the sake of adding some complexity, atrial fibrillation, especially chronic, makes the math almost impossible to calculate, accurately. Because it is not regular. Even at a resting HR, in a controllable situation, the poor bastards stricken with it can see fluctuations ranging 50 or more beats. It is not uncommon to see tachycardia a-fibbers go from 80 to 210 in a few seconds. Yikes!

So let's round it off again to a manageable 2K.
That is 14K a week and 56K a month.

Making data collection more interesting and dynamic is the fact that each of those 56,000 beats is recorded in four ways, the uptake, the peak, the rate of recovery and the time of recovery. So each beat has four parts.

Giving us some 224,000 data bits in any given month.

I am getting tired just thinking about all this. And I my have omitted few important details altogether.
Regardless, the pacer records it all. When we download it (I chose to do it without anethesia and cognizant - a trick I learned from Jack Bauer) the chart looks like sound waves compressed from a Mussorgsky symphony to one inch of screen space.

Yet the talented cardiology team can read it like we read comics in the Seattle Times.

In the time since the last download I have gone into a-fib a total of 7 times, with the longest lasting 4 hours and 44 minutes.

My log and records confirm that I was doing the same thing each time this cardiac event took place, research I find fascinating. So then, with or without rhyme;

Name that thing.

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