Estoy contando el ritmo.

I've known since the time we did EKGs on ourselves in med school that I have sinus arrhythmia.

Sinus arrhythmia: an irregular cardiac rhythm in which the heart rate usually increases during inspiration and decreases during expiration.

If you count a heart rate to the millisecond you would notice the difference in rate with inspiration and expiration on everyone. There's nothing wrong with it. It's physiologic. My cardiovascular system is just on the lazier side of things and therefore it's a rather obvious arrhythmia instead of virtually imperceptible.  

The other day John W., myself and one of our med students had a few moments of down time.  We grabbed one of the portable doppler machines and started experimenting on ourselves. At a spot where you would feel for a pulse, when you use the doppler instead of a pulse you are determining what kind of signal you can pick up from the artery.  For example, the radial pulse.  Place the doppler and you should get a nice biphasic signal. While holding the doppler there simultaneously slowly apply pressure to the brachial artery. As blood flow is reduced through the radial artery the biphasic signal will turn to monophasic and then to nothing as eventually enough pressure is applied to cut off the flow.  It's all physics that I learned once upon a time, but could in no way actually explain now. 

John W., hypertensive thanks to his genealogy, had a nice crisp clear biphasic signal demanding to be heard.  When it was my turn, without applying any pressure to the brachial artery there was already a barely perceptible monophasic signal.  And with even light pressure applied to the brachial, distal flow was cut off and the soft signal disappeared. But then combine that with the sinus arrhythmia and it gave me a 'Jaws' feeling. A soft beat that doesn't come when it's supposed to, then races to catch up with two quick ones before it decides to pause too long again. 

Well... the first 50 seconds or so of 'Jaws.'


This is also why I dance when no one else can see me.  I can't actually dance.  I've got no rhythm! ;)

Much Love.