A Heart Story - (Part 1) Delving beneath the surface

As a singer-songwriter, I'm used to writing from my heart.
Digging deep, going through my daily experiences, reflecting on the various things that life throws at me.
I live for those moments when inspiration strikes.

I like delving beneath the surface of what I see and what I experience,
to find the meaning behind the places I visit, the faces I see,
the conversations I have with people.

I cherish the emotions and stories that friends, family and strangers share with me, little vignettes of life...stories about relationships, both broken and newly formed.

I savour the moments between people when boundaries shatter and floodgates release long-stagnant tears or ripples of laughter that shake guts with belly-aching laughter.

I guess in the midst of paying all that attention to my emotional heart,
I forgot to listen to my own, physical heart.

A song from popular pop group Roxette from the 90's goes
"Listen to your heart, when it's calling for you..."
Well, I forgot to listen to what my heart was telling me.
In fact, I kept ignoring what it was trying to tell me.

About seven years ago, I was standing in line at the supermarket
check-out line, when I started feeling a little queasy and light-headed.
Then I noticed a funny pounding in my chest. Being a musician, I couldn't help but count along to the wierd rhythm; the syncopated, almost jazzy thump-a-thumps.

What a funny rhythm, I thought to myself, and stood there, stunned,
not sure what I was supposed to make out of it. The little dance lasted 30 minutes and even though it felt a little scary, I attributed it to stress.

Still, I went to see the neighbourhood doctor, got a blood test, and he
said that I needed to bring my iron levels up, and so I started
taking a multi-vitamin supplement. The hiccups, the little chokes, flutters and sprints my heart would cook up continued over the next few years, but they never stayed for long and they came by infrequently enough that I would notice them, then ignore them, attributing them to stress, a lack of sleep or perhaps a lack of iron in my diet.

But as it often is the case, the things that you ignore, come back to haunt you.

In July 2006, I was in Chicago to perform for the Chinatown Summer festival.
The performance went well and I enjoyed my time there, the organisers have always been wonderful and warm hosts and there is a vibrancy in Chicago's Chinatown that makes the city-girl in me feel at home.

The next day, I decided to go for a mid-day mass at Chicago's Holy Name Cathedral to check out the architecture of the place and also to spend some time with God. While getting up from the pew to receive communion, my heart suddenly started pounding away and something felt a little different this time around. It felt like someone was knocking on my chest from the inside, frantically trying to get out. It was 12.25 p.m.
I went to the restroom, tried to splash some water on my face, I tried holding my breath, I tried walking around, I tried kneeling, I tried praying...and nothing worked. My heart continued to race faster and I started panicking.
I took my pulse...200 beats per minute.
It was faster than anything I had ever felt before.

Maybe I need some food, I thought to myself, and so, though I was getting tired and light-headed, I dragged my suitcase and myself down a couple of blocks to Gino's East Pizza. I only managed to get in one or two bites.
By this time, it was 2.15 p.m And still my heart continued to race.

I was at my wit's end, and I knew that the time was fast approaching for me to catch my plane back to Los Angeles, so, packing up my lunch, somewhat in a daze, I started heading out to the street, to get to the subway so that I could get to Chicago's O'Hare airport. Looking back, I should have asked someone for help, but I felt embarrassed about telling a total stranger about a medical problem, and at that moment I could not think straight-
I was just going on 'automatic pilot'. I was alone, I had no clue where the nearest hospital was, and the thought ran through my mind that if I collapsed right there and then, nobody would have a clue as to what had happened.

I managed to stumble along the street down two blocks, when my heart finally stopped it's frantic sprinting. I was exhausted. It felt as if I had been running a marathon for the past 3 hours. 200 beats per minute for three hours. Something was not right.
And yet, I banished it to the back of mind and didn't mention it to anyone.
I don't know why.

Perhaps I was afraid to expose my frailty, perhaps I wasn't sure what to say...perhaps I was too embarassed...perhaps I thought it was just a one-time occurence that would not happen again.

But it did happen again, and this time, I was in Singapore for a Christmas Concert.
It was December 2006. We had a band rehearsal at the Esplanade Recital Studio for our Christmas Concert and I was looking forward to seeing all the band members again.

After exchanging warm hellos and smiles with my bandmembers, Joshua, Wen, Reggie and Ken, I sat down at the piano and was starting to play a few notes when I started feeling light-headed and felt a strangely familiar, pounding in my chest. "Please...not now...", I thought to myself.
I quickly excused myself and headed to the dressing room.
I took my pulse. 180 beats per minute. I held my breath, I sat down, I tried coughing, and nothing worked.
My heart continued its frantic pace and 20 minutes went by.
Finally, I said a prayer. "Please, please help me slow this crazy heart down. I need to do this rehearsal."
Amazingly, my heart immediately slowed. I went back out to the band rehearsal and continued as if nothing had happened.

Thankfully, the concert itself went well without incident and I headed
back to Los Angeles after the Christmas concert.

It was only in February 2007 when I headed back to Singapore again
to celebrate Chinese New Year with my family that I decided to see a cardiologist that specialised in cardiac arrhythmias, ie. a doctor specialising in heart rhythm disorders. I suspected that something was not quite right, and I knew I needed to seek professional help.

I had a consultation with Dr. Teo Wee Siong at The Heart Specialist Clinic in Mt. Elizabeth Hospital. He is a senior consultant and the director of electrophysiology, ie. the study of the heart's electrical system at the National Heart Centre in Singapore,and I knew that if anybody could figure out what was wrong with me, it would be him.

I described my symptoms to him, told him about my 3 hour episode in Chicago and told him how it seemed that these events would seem to come out of nowhere. I had no way of foreseeing when,how or why.
It was as if I had a phantom heart and I had lost control of it.
I told him about the bouts of chest discomfort and the bouts of breathlessness that seemed to strike me at random.
I had never mentioned any of it to anyone before, and it felt so good to, excuse the pun, get it off my chest.

"Your symptoms sound like a classic case of Supraventricular Tachycardia, most probably due to AV nodal re-entrant tachycardia." he said. What?
"You have a short circuit in your heart's electrical system that's causing your irregular heartbeats." He said simply as he took out his pen and began drawing blue circles around the AV node of the heart cartoon printed on his notepad.

Then he proceeded to explain how some people are born with an extra electrical pathway in their hearts. Our heartbeats are triggered by electrical impulses from our natural pacemakers, a node within the heart muscle that sends out signals to the heart to start beating.

In my case, he suspected that I had an extra electrical pathway which caused a 'short circuit' in my heart, thus causing multiple heartbeat impulses to go round and round, in a circle, resulting in sudden episodes of rapid heartrate that if left unchecked, might lead to problems, like a higher risk of heart failure or the likelihood of having to visit the emergency room to get medication or an electric shock to stop a runaway heart.

Great...I thought to myself. I have an errant merry-go-round in my chest because my traffic signals got crossed.

[Cue Joni Mitchell singing : "And the seasons they go round and round and the painted ponies go up and down. We're captive on the Carousel of time. We can't go back, we can only look, behind from where we came...and go round and round and round in the Circle Game."]

However, I felt an instant sense of relief. Finally, here was an answer to this phantom medical problem. It was real, it had a name and I wasn't just imagining it.
It wasn't as I had thought, been caused by stress, or anything in my diet.
I had been born with it and it just chose to rear it's head at this point in my life. Did it have a solution?

He suggested that I undergo a Catheter Ablation to correct my heart's rhythm disorder. I was a little shell-shocked. I thought he'd just give me some medicine and send me off on my way and instead, he had suggested a 'Catheter Ablation'- an invasive medical procedure to effectively destroy the source of the heart's 'short circuit'.

Dr. Teo told me to think about it and gave me some literature to read regarding this medical procedure. It was the only cure to my condition. True. I could take medicine, but it would not cure my problem. It would just help to ease the symptoms. He gave me some Isoptin pills, to take in case I had another episode.
"It will help to slow your heartrate if you have another attack."

And so think about it I did. I was nervous, I was confused.
I could not stop thinking about what the procedure entailed.
For a whole week, I googled, I researched and I talked it through with my family and my husband who were shocked that I had never mentioned anything to them about my condition before.

"Why didn't you tell us you had this problem?"
I guess I didn't say anything because I didn't know what to say. I didn't want to cause them unnecessary worry. How do you describe something that doesn't leave any evidence that it was ever there? How do you prove the proverbial 'Snuffle-laugh-phogus' that Big Bird from Sesame Street was always trying to prove existed?

Getting a diagnosis from a doctor gave me the freedom to speak up about something that I had only previously confided to my journal. I felt as if a burden had been lifted off me. It was good to finally share my little secret.

I found out that undergoing a Catheter Ablation would mean that I had to stay in the hospital for a day. I had never stayed in a hospital before and the thought of having to do so scared me.

I would not have to be under general anaesthetic, but I would be under heavy sedation. The operation would be done in the cardiovascular lab, where I would have thin wires threaded through a vein under my collarbone, and 3 more wires threaded through the vein in my leg and all these wires would, with the help of x-ray guidance, be threaded all the way into my heart.

Once in the heart, some of these wires would help to diagnose and confirm the type of heart rhythm disorder, and to help the doctor map out a picture of how my heart's electrical impulses worked. He could then find the exact spot in my heart where the circuit needed repair. Then one of the wires that had an electrode tip would be heated via radio frequency waves (yup, the same ones on the 500hz AM dial. Great...now I'm my own self-contained radio. kidding.) to a high enough temperature that it would 'burn' away the abnormal tissue it came into contact with. It would destroy the cells and the abnormal tissue, creating a scar in my heart that would prevent further signals being conducted through the errant pathway.

This scar would in essence, put a stop to my heartbeat irregularities.

As with any medical procedure, there were risks involved, such as the possibility of injury to the blood vessels or a blood clot causing a stroke or a heart attack, or one of the wires could puncture my heart, or if the 'burn' to the heart ended up accidentally modifying too much of my AV node, I might need a permanent pacemaker to control my heartbeat, but the literature I read indicated that the risks of any of these happening was extremely rare. Besides, Dr. Teo was an expert in the field and I knew that he had had much success with Catheter Ablation, having been one of the pioneers of the treatment in Singapore, and he had done over 2000 of the procedures in the course of his career. The procedure had a 95% chance of successfully curing me of my heart ailment.

Still, I was leaning towards not undergoing the procedure.
Taking life-long medication still seemed to be the less scary of the two options I had.

However, as luck would have it, I happened to mention my situation to my friend Vivienne over lunch and she said that it sounded like something that her mom had gone through a couple of years ago. I was so relieved to know that there was someone else I knew who had gone through the same experience. I spoke with Vivienne's mum and she reassured me that the procedure was relatively painless and that once she had done it, she had been cured of her condition.

I was also incredibly blessed to have recently gotten back in touch with a friend, Jack , a schoolmate from Raffles Junior College who was presently a cardiologist himself. I called him and we spoke about the procedure, the risks, the benefits, and he told me that as a friend, he would recommend that I go ahead with the procedure. It had a high success rate in curing my condition and the risks were low. "Think about it like having Lasik", he quipped. I personally am scared of having Lasik to correct my short-sightedness. Something about getting my eye cut by a laser did not particularly appeal to me.

However, I knew that I didn't want to go through life wondering when I would have another attack like the one I had in Chicago. I knew that my symptoms had gotten worse over the years and in all likelihood would continue to get worse.

I knew that I could not afford to have them while I was in the midst of performing on stage. I had already experienced a couple of short episodes while performing in Los Angeles and they were not pleasant. I knew that I didn't want to have to risk visiting the ER repeatedly over the course of my life.

With that in mind, I decided to go ahead with a Catheter Ablation.
it was a scary decision for me, and in the course of the next few days,
I sent out sms-es and emails to some of my friends in Singapore and in Los Angeles, asking them to pray for me.