Wonder Ball 2

Thought about wonder ball again this morning when the program director told me that a new client who (among her many other medical problems) has an internal cardiac defibrillator that keeps on shocking her because her potassium level is unable to be maintained, is being sent for cardiac rehab. A low potassium level, particularly in someone who has underlying heart problems, may result in lethal heart rhythm disturbances. Knowing that this program, currently in a "freestanding" facility, will soon be moving to an "in hospital" setting made this an easy call. She won't start until after the move. My feeling is that if this person is unstable but needs to have low level rehab, it's better to do it in the hospital.

This blog won't be a forum for my medical "war stories" but I'll tell you this one: In 1992 I was performing a stress test in the office on one of my long term patients (not clients), then in his 70's. After a few minutes I noticed that he was having a disturbing number of "extra" beats (PVC's) and short bursts of Ventricular Tachycardia. I immediately stopped the test and had him lay on the cot next to the treadmill. Within seconds he developed Ventricular Fibrillation. In other words, he had no effective heart pumping and would be dead within minutes. We, of course, had a defibrillator right there and I gave him one shock (like you see in E.R. on TV) and his regular rhythm reappeared on the monitor (Thank God). He subsequently had Coronary Bypass performed and an internal defibrillator placed. I saw him last summer- still happy as a clam-now in his 80's and frustrated only in that he can't bowl or play "table-tennis" ( I kid him about this and tell him that you can tell a serious player when they call it table-tennis rather than ping-pong) as well as he used to. He was actually thankful that the incident had occurred back in '92 since he had a Nordic Track at home and had been using it every day. In the scheme of things I suppose it was better that his heart had stopped with me around rather than when he was alone in his basement-but I could have done without the drama.

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