Calming influence

Family / June 25, 2018

Heart patient's experience leads her to pursue nursing

At 18 years of age, Michelle Nagode, now 28, began experiencing symptoms including rapid heartbeat and fainting spells that were triggered by things like heat and anxiety. This sparked a series of hospital trips, doctor visits, and misdiagnoses before she was finally diagnosed with Wolff-Parkinson-White syndrome, a condition in which an extra electrical pathway in the heart causes a rapid heartbeat.

Normally, electrical signals follow a certain pathway through the heart which helps the heart to beat regularly and prevents it from having extra beats or beating too soon. In those with WPW syndrome, some of the heart’s electrical signals go down an extra pathway, causing symptoms including abnormally fast heartbeat, palpitations, shortness of breath, dizziness, and fainting.

Having been adopted, Nagode has no knowledge of her medical history but said WPW is congenital 99 percent of the time.

“The majority of people, when they have WPW pattern, it’s benign, so they don’t have any

symptoms and they just live with it. Most people don’t even know they have it. But WP

W syndrome is where it can cause serious tachycardia — fainting. In my case my heart rate would skyrocket. It’d go above 200 and my blood pressure would just drop — it’s almost like my body would reset itself and I’d pass out,” Nagode said.

When the fainting spells began to worsen, Nagode saw several cardiologists and no one seemed to know what was causing the problem. She finally ended up at Baptist Health Medical Center in Little Rock where her doctor ordered a cardiac electrophysiology study, a minimally invasive procedure that tests the electrical conduction system of the heart to assess the electrical activity and conduction pathways of the heart.

“They went in and saw that I had this accessory pathway and then what they did wascalled an ablation, where they actually cauterized that extra pathway and attempted to close it up. That in itself fixes a lot of problems. It’s a catheter ablation so they go in through the groin area,” she said.

The ablation was successful and Nagode has not fainted since the procedure in 2014, though she does still have some underlying issues.

“It was a huge relief,” she said. “But, what they explained to me is, because it went on for so long, I have atrial fibrillation and I have super-ventricular tachycardia, both of which cause extremely high heart rates. I have trouble exercising. I’ve tried to lose weight and it’s very hard because I can’t do any sort of cardio.”

Nagode said heat is still a trigger and she has to be careful about overexerting and overheating herself.

“If I take a hot bath — which is a little sad because I love hot baths — I’ll feel sick to my stomach. It’s not your typical nausea feeling; it’s almost in your stomach and in your head. You just feel off. I’ll flush really bad and I’ll be able to feel all of my pulses because my heart beats so hard. With that extra pathway, your heart doesn’t pump the blood the way it’s supposed to. My hands will go numb, my fingernails will turn blue and my heart rate will go up, sometimes above 200. A normal resting heart rate is between 60-80,” she said.

… I want to be that person who is going to calm a patient down, who is going to be their advocate, who is going to metaphorically hold their hand throughout the whole process.

Hiking is another activity that Nagode said she enjoys. She is still able to do some physical activities but has to remember what her limits are and take regular rest stops. She also takes a high-dose beta blocker daily and must always remember to bring her medication with her when she leaves home, as she is instructed to take it as needed on top of her regular dose.

Smoking and drinking alcohol are also triggers.

“If for some reason I don’t take my medicine with me or if I don’t pace myself, if I go a little overboard, it is very noticeable and I will have those dizzy sensations and feel like I’m going to pass out,” she added.

Nagode is currently employed at Melinda’s Coffee Corner & Cafe in Hot Springs Village and plans to return for her third semester of nursing school in the fall.

She credits her interest in becoming a nurse to the nurse that was present in the room with her during her cardiac ablation in 2014.

“I had to be awake for the whole procedure so it was terrifying. They use radiation, so the cardiologist stands behind a lead shield and he has to manipulate by watching a screen, and then I’m covered in lead pads. The whole thing is just terrifying. This one nurse was just standing behind me holding my head and I was just crying the whole time. All she did was wipe away my tears and talk to me the whole time, and that’s when I said, ‘That’s what I want to do.’ I want to be that person who is going to calm a patient down, who is going to be their advocate, who is going to metaphorically hold their hand throughout the whole process,” she said.

For those that, like Nagode, may have a condition that causes their heart rate to speed up, she suggests performing vagal maneuvers as a way to temporarily slow a heart rate down right away. Some of these include holding your breath and exerting downward pressure on your body. Another type is the cold water treatment, which consists of immersing your face in icy cold water for several seconds or placing a bag of ice over your face for 15 seconds.

“The scariest thing about it for me is that chance for sudden cardiac death, going into cardiac arrest. Ever since I found that out, that’s been in the back of my mind. It’s happened — it’s rare, but it happens, and whenever my heart gets really fast I don’t make it any better because I start having anxiety,” she said. “If people think that they might have something like this, better safe than sorry every time. You don’t have to get an ablation to find out if you have this. You can get an EKG and you can get an electrophysiologist to study it and to say, ‘Hey, it looks like you’ve got this so let’s take another look.’”

When she isn’t working, Nagode enjoys spending time with her son, Spencer, 9.

Photography by Grace Brown

Lindsey Wells

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June 25, 2018