It’s been a very busy few weeks. Medicine is like that — seldom is “business” steady. Like rainy weeks in the southeast when you think it will never be sunny again, there are weeks when you think everyone’s atria are fibrillating. So there were shocks, and burns, and wires installed. The heart rhythm was rocking, and so were we.
But in all this fury two cases stand out as a reminder that in spite of, not always because of, what we doctors do, the human body can right itself — like it did before their were drugs, procedures, and surgery. (Keep this quiet, though.)
Case 1: A semi-emergent consultation for atrial flutter (AF’s crazy sister) came in. “Something has to be done, Dr. M,” was the message. She was symptomatic and scared (not necessarily in that order), but after a bit of simple doctoring (a pill), the heart rate had slowed and the symptoms abated somewhat. Then after a heavy dose of an AF doctor’s greatest weapon, reassurance and education, we mutually decided on one of my secret treatments for acute AF/AFlutter: A deep breath, a chair, a book, and time. Just in case, though, a cardioversion (shock) was set up for the next morning. I knew that since this was a first episode, that given some time the heart may right itself, without any fury.
Bingo. The text message came the next morning: “Cardioversion cancelled. Patient converted to sinus rhythm right after you saw her yesterday.” (Grin.) Read more »
*This blog post was originally published at Dr John M*