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Cali

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The cardiophile and the heart patient part 3

Hi everyone! So, finally, after almost 2 years and after some people asked for a third part more recently, I finally had the time with this quarantine to make it. This is the third part of the love story between Josephine, a Cardiophile, and Elliot, a young man with heart problems. If you'd like to read this part, I recommend reading part 1 and 2, both were posted here sometime ago as well

I hope you enjoy it, and please give me some feedback on what you liked, or not, and you can even suggest other kinds of stories, we are still under isolation here, so, I might have time to write something else!

After a year and half of dating and being financially stable, they decided to move in together to an apartment on Elliot’s town. They had a room for Josephine to work on her projects and another for Elliot to practice the Piano and teach as well. There wasn’t much room left for anything else besides a kitchen, a bathroom, and their room. They weren’t exactly rich, even if Elliot came from rich families he didn’t like to depend on them, so they managed a way to live inside their studios. They both preferred the beautiful and calm place that Josephine grew up in, but the fact was the modern art public that their jobs required could only be found on a bigger city, on top of that, Elliot’s medical needs were much closer there, so Josephine had to adapt to be there more permanently, and living together with Elliot was the only thing making it easier.

They had a big window with a view to the city right at the side of their bed, on summer days where he didn’t have to work and was too lazy to be practicing, Elliot used to lay down there, with bare chest, feeling the wind caress and cooling his skin and watching the birds fly around looking for another spot to land.

When Josephine entered the room, Elliot was distracted looking outside, but really just looking to nowhere. She sat on the bed and touched his chest with her fingertips, going forward and backwards on top of his heart surgery scar and playing with his long hair with the other hand.

- Are you finished with your projects for today Jo? - Elliot asked looking at her with very sleepy eyes while touching her face.

- I might be… can’t resist this sight of you, laying here with the sun caressing your skin, so gorgeous…you’re so pale that it looks like your skin shines a bit, and so does your scar, I should paint you like this someday - saying this Josephine kissed his lips, then his scar, and placed her head on top of his chest listening to his heart beating. It was relatively slower than average since he was so relaxed and comfortable but easily got faster after those words. Elliot just laughed at the idea shyly and caressed her head on his chest.

Even tho Josephine did a great use of Elliot’s gift, the stethoscope, there wasn’t anything as beautiful as listening to his heart directly from his chest. There was an emotional and intimate experience on such an act that could never be replaced by anything else. Listening with stethoscope had a much bigger definition of sound, watching Elliot’s EKG’s and Echocardiograms was an amazing experience since she could see his heart performing, and his debilitation and conditions were much more obvious that way, but even so, there wasn’t anything as personal as laying on his chest, feeling his skin and scar, the rise and fall of the chest, and listening to that heart, skipping, getting faster or slower, but still beating. However, such calm days would eventually be challenged…

                                                                                                                                                     

Josephine was painting on the atelier, and Elliot was giving a private piano lesson in the other room. They were two artists in love, working on different types of arts at the same time and many times used the studios for private classes on painting or piano.

Elliot was finishing the class of one of his students when suddenly he started feeling discomfort on his chest. It felt like his heart was fluttering, arrhythmic, and overall beating at a faster pace than usual. It was normal for him to have some arrhythmia episodes, especially tachycardia since his heart rate could be easily elevated with little exertion, but that was something else.. he had experienced something like that before, but it eventually got solved after his last surgery and an increase of his heart medication. Elliot tried to hide his discomfort from the student since the boy was already preparing to leave but as the episode got stronger he couldn’t help but to take his hand to his chest and feel his heart painfully beating fast in his chest while getting dizzy.

- Mr. Elliot, is something going on?.. - the student was a relatively new student and had no knowledge of Elliot’s heart problems and Elliot was only 26 so he didn’t think it could be the case.

- Ah…don't worry Miguel… you can go know, I just need to rest for a while. See you next Friday afternoon as planned. - Elliot said to the student hoping the boy would go away, he hated to worry people, it was already bad enough for him to feel like he makes Josephine worry for him all the time, he didn’t want more people doing that. Since the boy was young and new there, he just did what Elliot told him. As soon as the kid closed the door, Elliot held his chest tight and sat on the ground with his back on the door, it was getting difficult to breathe, he wanted to call Josephine but he was starting to feel unable to do it…

However, almost as if she felt something, Josephine came out of her atelier, to find Elliot in that state.

- Oh Elliot, what’s going on my love? - Saying that she quickly helped Elliot to lay on a couch and checked his heart rate. She could also feel the fast and irregular shivering it was making on his pale chest.

- I… I haven’t felt like this in a long time... I think it might be Atrial Fibrillation episode, I used to have some…my heart is completely out of rhythm…

- I’ll call an ambulance Elliot, this could be a heart attack and even if the episode is over when they get here, you need to be checked… - She held Elliot’s hand tight on his chest and proceeded to call. This scenario was something that had happened some times before, in a little more than a year and a half of being together, Josephine had to call an ambulance on Elliot more than a couple of times, and there were also the times where she drove him to ER, and the times he didn’t get to go to the hospital but had moderate episodes at home. Elliot felt worse with the pain he was causing on the woman he loved than for the pain of his frail heart struggling to pump efficiently. With that thought and sight, he passed out before the ambulance arrived.

                                                                                                                                                             

When the ambulance arrived and connected him to the monitors, it was visible that it was indeed a severe Atrial Fibrillation episode, they were lucky to still catch it on the monitors because it could be difficult to detect once it was over.

After arriving at the hospital, Elliot was immediately rushed to the cardiology unit and connected to the heart monitors, blood pressure cuff, oxygen mask, IV lead, defibrillation pads... His own cardiologist was working at the moment so he was called to the emergency which helped the other medical team understand the best procedures for him. Since Elliot’s heart didn’t convert with any medication and was almost at 200 bpm they had to cardiovert him, and could only bring his heart back to a normal rhythm and pace at the third shock.

During all these procedures Josephine had to wait outside and she could only watch it by the acrylic window. It was horrible. One thing was to watch regular check-ups, she did it regularly with him since he had an EKG almost every month, but watching all those leads covering his chest, the defibrillation pads, the oxygen mask, a sedated body, that all just made her own heart tight for his own. She couldn’t imagine a life where she didn’t have Elliot with her, where she didn’t have his heart beating under her ear and hand when she sleeps. Seeing him being shocked was the worst part. It wasn’t the first time for Elliot, he had been cardioverted and defibrillated quite a lot before his last heart surgery, but this was the first time since then, so Josephine never witnessed such a scenario. Every time they shocked his chest she feared his heart would stop permanently…but after that third attempt, his heart got from 202bpm to 86bpm so she could finally breathe deep, and some tears of relief were shed.

As soon as the doctors stabilized him and moved him to a private room, she finally could be with him. He was still under an oxygen mask and full of leads from the heart monitors, but Josephine could at least be at peace when the numbers and rhythm at the monitors looked normal. Finally being a cardiophile could be of some use to her, she could somewhat understand what was a normal EKG reading and what was not. Since he remained unconscious from the sedatives she just caressed his hair and scar and looked at him dearly. His long black hair was all over the place, but even like that, all wired up, he was the most beautiful man for her.

- Josephine, how are you my dear? - said Elliot’s cardiologist entering the room.

- Oh…I’m better now that he’s also doing better… - she said still looking at him - what happened with his heart doctor?…

- Well, he had Supraventricular tachycardia episode, Atrial Fibrillation to be more specific. He already had other episodes that showed on previous Holter exams, but they weren’t as severe… we though his last heart procedure and medication had solved part of this problem, but maybe we’ll need another solution…

- I see… he did say he thought he was having one of those before passing out. What other solutions do you suggest, doctor?

- We can increase some of his medication, but it might have some side effects that for someone this young would not be desirable and I don’t think it would be effective since these episodes are getting severe, we had to cardiovert him today as you saw, nothing else worked...I think that at this point Elliot could benefit a lot from an ICD, an implantable cardioverter defibrillator.

Once again, being a Cardiophile meant that Josephine knew very well what an ICD was but she decided to ask more about it anyway - What exactly an ICD would do for his heart, doctor?

- An ICD is a small device that goes under the skin of the patient and that connects with the heart. Basically, it can correct the heart on some episodes with small electrical impulses every time it detects irregular rhythms, or just tachycardia or bradycardia pace. If those impulses don’t work, it will cardiovert the heart, and if that also doesn’t work it will pass to defibrillation to correct a dangerous rhythm. Usually the patient won’t feel anything regarding those small impulses, but he will feel some local momentousness pain if the heart gets shocked and it’s still needed medical evaluation after it occurs sometimes, but it can save lives… In this modern version, ICD also works as a pacemaker, and he will need to replace it every 3 to 6 years depending on how much shocks his heart will need. I think Elliot would be a great candidate to getting one…

- It sounds like a good option indeed, but...I don’t know, knowing Elliot as I know, I don’t know if he will agree to have a device on his chest that reminds him every time that he has heart problems…specially with those shocks, it sounds quite scary…

- Yes, you’re right about that… I already had this conversation with him some time ago, but he didn’t agree on it, and since his condition improved after last surgery I didn’t force the idea but right now my dear.. we might be talking about a lifesaver. Medical teams might not be fast enough if his heart stops, but this little thing can be enough to save his life. - Saying this, the doctor checked all the monitors, changed some more words with Josephine, and then left them alone.

When Elliot woke up, he still had to be on a nasal cannula since he was still not able to breathe well and was covered with electrodes and leads. Before waking up Elliot already had another episode that could be controlled with adenosine and heart pacing, but that sight of 2 episodes in less than 24 hours was enough to get Josephine and Elliot’s doctor sure to make Elliot accept the ICD.

- How are you feeling my love? - Said Josephine kissing softly his lips and caressing his hair while adjusting his canola - you are at the hospital, you were rushed to cardiology unit after you passed out at home, they needed to perform a cardioversion on you so they sedated you, and then you had another smaller episode during the night.

- Oh … yeah, I don’t remember anything…just feeling that strange chest pain and then collapsing, I don’t really remember anything else.. - Elliot said while still trying to understand everything and being annoyed with the loud beeping sounds of his heart monitor - … I’m so sorry Josephine…

- No Elliot! You know it’s not your fault, it’s ok…we both are ok now, that’s what matters my dear, it’s ok! - Once more Josephine kissed him, this time also on his forehand and caressed him.. - Look, your cardiologist talked with me and…he thinks that you might need an ICD… What do you think about it?

- I… I don’t know Josephine, I don’t really want it, but I can recognize that I might need it… - Elliot said it while looking at himself, his chest, his scar, all those leads, and annoying monitors. Elliot hated so much all of that, and more than it, he hated that Josephine had to witness all of it and be constantly worried. He remembered at that time why he got more separated from his family, it was because of his mother, he couldn’t stand to make her worry about his health that much.

- Well, your doctor was called here now since you woke up, and he will talk with you about it… I don’t want to force you to anything my love, and I won’t, but, from what your cardiologist said to me, I do think it’s the safest option for you… and regarding me my dear, you know I just want the best for you and your heart. I don’t care about the scars, the procedures, the medications, the constant exams, the lump on your left chest that would appear on such case..I don’t care about any of it, I just want you to be better and safe and listen to your heartbeat for a long long time… - Saying this Josephine retired herself from the room and let the doctor talk privately with Elliot.

That discourse really got to Elliot’s heart and soul and it was visible on the monitors. His doctor checked everything and had a good listen on his heart and after all that, he talked about the ICD procedure with Elliot once more, and eventually, he accepted it. The doctor used a very powerful weapon to make Elliot accept it, he used Josephine. He just had to say “Look, Elliot, if you don’t put an ICD on your chest as soon as possible to help your heart pump effectively, it will come a time where doctors won’t be fast enough and your heart will give out. You’ll leave a woman that loves you broken for life, she will never recover from losing someone she loves this much when it all could be prevented” the sight of Josephine crying over his dead body was what made him say yes right away, and with that, the doctor scheduled the implant and prior exams.

                                                                                                                                                       

Some months after that, Elliot had already had the procedure. At first it was difficult to adapt. He was very depressed and anxious about it, every time he felt a tingle or shock on his heart it was like a reminder that he was chronically ill at 26. And the shocks could be very strong, when his heart was getting paced or shocked it was painful, he had to rest for a while and it made him anxious for when the next shock would happen… eventually, he got used to it, in the end, that wasn’t the only reminder that he had heart problems, there were also the medications he took daily, the exams, the heart surgery scar… what really matters was that in despise of all of that he had found love, and now not just a girlfriend, but a future wife. Elliot had proposed to Josephine after coming out of the hospital with the ICD on his chest and obviously she accepted it.

During the night and also on lazy sunny afternoons where they could just relax, Josephine caressed not just the heart surgery scar but now also the place where the ICD was, while still listening to his heart.

- Doctor said only I can feel the shocks but you still tell me that you can feel them happening sometimes too, isn’t it Josephine? You might be going mad my dear - Elliot said while caressing her head and watching the birds at the window on a summer day.

- I swear I can Elliot, I can feel it too when it’s pacing your heart… and I’m happy I can, it means your heart is still beating… I love you so much Elliot.

- I love you too Josephine, thank you for taking such good care of my heart. - Eventually, they both fell asleep covered by the golden hour of that sunny day.