Don't Curse the Nurse!

Sharing support with stories & humor

Takotsubu Cardiomyopathy

broken heartIt’s the Japanese term for broken heart syndrome, an event in which the heart has an acute physiological weakening in response to extreme stress or grief. It can resolve, although sometimes it doesn’t. (We all loved James Garner in ‘The Notebook’ because the bittersweet ending was believable.)

On echocardiogram the heart balloons to a distinctive shape resembling that of a Japanese octopus trapping pot. The pot has a wide base and a narrow neck called the takotsubu.

There are dozens of documented cases, the most significant being the 2004 Honshu Island earthquake. Post this horrendous event; there was a 24-fold increase in the incidence of Takotsubu cases. In almost every case, the patient lived near the epicenter.

It’s unfortunate that we, as a general population, see stress management as some type of ‘Hippy’ trend reserved for Southern Californians or Bohemian artists living month to month. The number of clinical cases reviewed concerning the relationship between hypertension and stress, there are too many to count. If you have any other comorbidities, stress is often placed low on the list of items a physician addresses.

Of course, correlation does not prove causation.

I’m a heart patient and a nurse.  I see the issue from both sides.

I wanted to share this after reading an article about it in The New York Times and reflecting on how I have let stress dance around the edges of my heart.


The first step is acknowledging there is a problem, right?


Survey says…

A lot of surveys should be landing in my parents’ mailbox over the next week or so. Between the two of them, in the last four weeks, there have been two ER visits (one that turned into an admission), one outpatient surgery, at least one diagnostic test, and I’m sure they’ve had labs done at a facility owned by the area hospital they’re frequenting. One of these visits will not garner a positive survey.

After my Dad’s outpatient surgery, while in recovery, his blood pressure kept climbing.

I observed the nurse get an order, put the smallest dose anti-hypertensive medicine possible in the tubing port of my father’s practically bone dry IV, not bother to flush the medicine with 10 cc of normal saline, and then not hang another IV bag and open it up some. She retook his B/P in under three minutes.

I remember starting to clench my jaw, but then she repeated the dose. (She had an order.)


The medicine never reached his vein.

At this point I was struggling to have that ‘we nurse stick together’ comradery.

The evening call nurse came over seconds later. It was 7:00 pm. (Call staff takes over at this time.)

She disconnects the long IV tubing, leaving his IV, with a short section of tubing, in.

So there’s his medicine, in the tubing.

They take my Dad’s pressure again.


The second nurse tells him he needs to relax. She tells him that he is tensing up. They take his pressure again.


They take it again a minute later. 205/105. He’s going to have a stroke and I’ll need to kill a nurse.

I tell nurse #2 I need to speak with her privately. She complies. I tell her, with my jaw clenched tight, exactly where I think that B/P medicine is and why. She returns and re-doses my Dad and flushes the medicine in with syringes filled with normal saline.

Two minutes go by.

B/P 168/95.

He’s home and fine. That’s the most important thing. I’m still debating whether to write a letter to the hospital or wait and see if he gets a survey.

Either way, it’s not good. Someone’s coming down a notch.



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