Friday, March 8, 2013

"Woosh woosh" goes the heart...

     It was one of the most engaging topics I studied in last semester's Anatomy and Physiology course: the pathway of blood through the heart. Unlike the daunting nervous system with different pathways and mechanisms for making my muscles move, with that complex brain and all of its centers added in, the heart has a predictable, (sort of)simple path. We won't talk about reading EKG's with their QRST pattern. I'm not so looking forward to that in nursing school, but I'll get through it. I have to. But I digress.
     Additionally, one of the more unique aspects of my volunteer work on different units at various hospitals is the ob/triage unit at my downtown hospital. I've been on telemetry, couplet (postpartum) care, and the emergency department. But on OB triage as I walk through the halls to the resident's lounge to assemble patients charts, I hear that distinct whoosh whoosh whoosh sound by the nurse's station. I see the monitors with their blue and red squiggly lines and I know that somewhere, a baby's heartbeat is being recorded and monitored for safety and informational purposes. If that heart rate changes and the line tracing becomes concerning, information can be gained about how that baby is tolerating labor. (Although, Electronic Fetal Monitoring is not an exact science and is rather subjective in the "gray areas.") If a baby does not appear to be tolerating labor well, various things like re-positioning the mother can be done to improve the baby's heart rate. Sometimes a cautious "wait and see" approach is appropriate. At other times, a c-section is performed to avoid what could be a deteriorating, life-threatening situation.
     It's the baby's heart beat that indicates these decisions.
A fetal monitor "strip" that records a baby heart beats
 and  the mother's contractions.
     A baby's first heart beat begins about day 22 after fertilization. That's about three weeks from an egg and sperm meeting to that first historic, significant, tiny  whoosh whoosh whoosh sound. I have begun to ponder this incredible event. God starts that heart beat and programs exactly how many times that heart will beat until it does not beat any longer. This is an incredible thing to ponder. It sounds so simple - the opening and closing of heart valves that gives that whooshing sound is pre-programmed with a distinct beginning and end. Of course, some people's hearts do stop and they are revived. Eventually, though, every dead person had that last, pre-determined whoosh.
     Oh....the reality of this is soo painful. It seems most painful when that apportionment of heartbeats is much smaller than the average. I looked up some information and did some calculations. The "average" person has about 42, 075, 840 heart beats per year. If someone lives to age 70, which is young compared to the increased average life span in the U.S. being in the early 80's, then that heart will beat approximately 3 billion times. If this is a hard number to wrap your brain around, imagine being given $3 billion dollars to spend however you wanted. That's a lot of money! Those are a lot of heartbeats.
     Sadly, though, with my two miscarriages that number was much smaller. My first miscarriage ended at about 11 1/2 weeks. I don't know when that baby's heart stopped beating, but at around 6 1/2 weeks pregnant we saw her (I'm sure it was a girl - what else?!) heart beating. I don't know the exact number of beats, but at 9 weeks gestation her little heart would have beaten about 4,320  times. And there was a moment when it didn't. When the obstetrician (not my regular doctor) did the ultrasound she keep pressing the transducer around my belly and stated, "Are you sure you saw a heart beat? I don't see any heart beat now. Are you sure?" This woman was seriously lacking sensitivity and compassion  - UGH! With my next baby the pregnancy ended shortly after it began and there might only have been a heart beating for a couple of days. Everyday  however, was precious to me and to God. For whatever reason, God gave me a little life and then He took it. I do have much peace about those losses. It is particularly helpful that God generously gave me so many more healthy and happy babies after those two that departed before they saw the light of day. Now, they see the glorious light of their Creator and my sweet Savior, Jesus. But I digress.
     Several weeks ago a young man in our community shockingly died of complications from a sudden heart attack. It has devastated our little town. He was a popular, well-liked young man. I remember him serving me coffee on a study outing one evening in late fall. He seemed very sweet. He was 23. And he is gone. I calculated the average heart beats he was given and it was around 967, 744, 320. Being so young, he didn't even hit the 1 billion mark.
     I'm not exactly sure where I am going with this post, only that I am trying to tie some strings together and find comfort in this young man's premature demise. As I proceed with my nursing career, eventually working on labor and delivery, I will have the pleasure of hearing that trademark whoosh sound many times. In fact, I will go through rigorous training to view those heart and contraction patterns to detect any possible problems that will require me to consult with an obstetrician to promote the best outcome for mother and baby. What a weighty calling! And I feel like I am being primed for it - one heart beat - WHOOSH - at a time.