July 30, 2008

As If Infertility Wasn't Enough

My seemingly totally healthy, normal 33-year-old husband isn't so healthy after all. In fact, he could keel over and die at any moment. And without any warning.

That is the verdict of a cardiologist he saw today.

All of this drama started a few months ago, exactly one week after my last post. We went out of town for Mother's Day weekend. I just needed to escape, so I even went so far as to tell my boss I would be in late on the morning after Mother's Day, because we went to a resort a couple hours away from home and I refused to come back on Sunday night. I just wanted to ignore that whole day.

We had a lovely time. I came back totally relaxed. Then half an hour after we got back, we got a phone call from R's mom. R's dad had gone to the hospital that morning to have an electrophysiology (EP) study done on his heart to determine what was causing an irregular heartbeat. There were complications, and the doctor had to shock him four times to get his heart back into a normal rhythm.

We rushed to the hospital. Thankfully, R's dad made it through. The doctor wound up removing the pacemaker he had put in a month before and instead replaced it with a defibrillator. Then the doctor dropped even bigger news: He felt it was likely that R's dad has something called Brugada's Syndrome. It's a rare condition, it's heridetary, and the most common way it presents itself is sudden cardiac death in a seemingly normal, healthy 30-something man (sound familiar?) who has experienced no prior warning signs.

There was some question at first about whether R's dad really had it, so it took a while to work through the process of getting a second opinion with a different cardiologist. The second cardiologist tended to agree with the diagnosis, which means that R and his siblings have to be tested.

R was the first one to get tested. His appointment was today. I wasn't able to go with him because I had a meeting at work that I couldn't miss. It's funny - after so many years (5 1/2 and counting) of infertility, R is totally dependent on me for all things medical. On the way to the appointment, he calls me from his cell phone and asks, "Um, where am I going?" I said, "The cardiologist's office..." He replied, "Yeah, I know that. I mean, what is the address? Where is the building?" Thank God I was still at my desk and able to take the call, or else he would have been driving around town without any chance of figuring out where he needed to be! He also printed out my list of questions and told the doctor, "My wife will want to talk to you...When can she call you?"

He had an EKG done, and based on that, the doctor thinks it's pretty clear that he, too, has Brugada's. I told him to text me when he was done - bad idea. I got the bad news while I was sitting in a meeting with my boss and several of my other co-workers. One of them (who knew about the appointment) saw my face blanche when I read the text.

So in two weeks, R will have an EP study done. As part of the study, the doctor induces cardiac arrest in order to see how the electrical impulses are being transmitted. While he's doing the study, he will determine whether or not R needs to have a defibrillator implanted.

So there's a very real possibility R may spend the next 60 years (God willing that long) with a defibrillator in his chest, ready to shock him back to life if his heart suddenly goes into an abnormal rhythm. It also means that his hopes and dreams of getting his private pilot's license go out the window, because the FAA won't allow you to fly (even general aviation) if you have a heart condition. He was also considering aviation as a backup career if his current job is offshored.

There are smaller consequences, too, if he has to have the defibrillator. Such as, he couldn't have an MRI. Being as medical-focused as I am, I'm wondering what happens if he winds up having some other sort of health issue down the road and an MRI is the only test for it? And then there are other little things, like he'll have to be hand-searched when going through airport security, because he wouldn't be able to be wanded or pass through the medical detector.

We're actually leaving in less than 24 hours to go out of state to the clinic we've chosen to work with so that he can give a back up sample for our upcoming cycle and so that we can meet with the genetic counselor. We're going to cycle again this fall, and then have CGH (testing of all 23 sets of chromosomes to see if the embryos are chromosomally normal) before we do a transfer. One of the things we'll be doing while we're at the clinic is meeting with a genetic counselor (required of all couples undergoing CGH). I guess we'll have to add Brugada's to the list of things to discuss...