And we will just take each day as it comes...

Yeah, I said that. Well, what came was another trip to the ER.

I woke up on day two in St. Louis feeling the same feeling I had felt just before the lights went out and I landed in the New Bern ER. Not nearly as intense this time. It was spooky but faded away in about two minutes. It seemed pretty weenie to make much of an issue out of a minor cold sweat and and being a bit light headed for two minutes while getting out of bed. So I didn't say anything to anyone. But then it happened sitting in a chair reading. Then it happened standing in the shower. And it happened again while working on a small project with Deb. Clearly something was amiss. Deb and I talked it over but in the end I suggested we just go to the ER. You know I was spooked when I'm the one suggesting a ride to the hospital.

We got to the ER in the early afternoon. By then the weirdness was showing up twice an hour, which went on throughout that day, all night, and well into the next day. There was much debate over what was going on, but whatever it was, it seemed to be getting worse. The last time around this thing came within a whisker of being fatal, so there was a good bit of tension being tossed into the mix. We spent the night in an observation unit under the watchful eye of some truly wonderful nurses. This morning a Cardiac Doc showed up, sat down, and talked through the whole history of this thing from the initial event on the boat in Oriental to her sitting with Deb and I in St. Lous. After a bit she got up, walked over to the white board now a part of many hospital rooms, and wrote, “Neuro-cardiogenic-syncope / Vasovagal syndrome”. "That", she said, "is what I think is going on". That's good. What does it mean? 

It means that my brain, for reasons unknown, is commanding a dramatic drop in blood pressure. The long version of the fix?  My pacemaker needed to have a trigger point added. The one I already had fired the thing up when my heart rate dropped below 60 BPM bringing it back to a 60 BPM minimum. The one I didn't have, but needed, would fire the thing up when my heart rate was dropping rapidly. It needed a trigger at 70 BPM during a rapid fall that would bring the rate up to 85 BPM for two minutes, thus offsetting the falling BP. The short version?

My cyborg implant needed an upgrade.

A “wand” to talk to the thing in my chest and a fancy looking iPad were produced. The good Doctor and the Head of her department worked out settings they thought best, waved the magic wand, and that was that. As fate would have it, it was about time for my next event. (You know things are not going well when you can look at a clock and predict a potential fatal heart problem.) They walked out to the nurse's station to watch the monitors. A few minutes later they walked back in and asked if I had felt anything. I had not. They smiled. The monitors had clearly shown a plummeting heart rate followed by the pace maker taking over to catch the falling B/P with additional beats. Several hours have passed and there has been no repeat of the weirdness. Later my nurse came in and started an IV of fluids. A tune up and an oil change. Problem solved.

The Doctors suggested I stay the night to be sure, something to which both Deb and I were more than glad to agree. I'm not sure how many close calls one gets in a single season, but I think I may have reached my limit.

Deb did some reading and found that “Neuro-cardiogenic-syncope / Vasovagal syndrome” can be triggered by exposure to excessive heat and dehydration. Looking back on the summer's activities? Yep, guilty. Having a pacemaker installed and then “recovering” by living and working on a boat with heat indexes of 110+ might not have been the best plan. Who would have thought? Deb also thinks that I had a sub-conscious hint of what was going on—the reason for my eagerness to get the boat parked and get back home to St. Louis ASAP. Maybe. After all, we landed in St. Louis and barely two days later I landed in the ER...again. Which would seem a pretty good chunk of luck if that is what it was. As difficult has this summer has been, there is no question we have escaped some ugly possibilities by some very thin margins. Sitting in this hospital bed, feeling pretty good after a very uncomfortable day, and heading back to a house full of grandkids soon? 

I don't mind sitting in this bed. Take each day as it comes.