MW_Secret_files/Erotic Dreams.pdf - Medwords.com.au

PRACTICE TALES
Rings and Ribbons
I had known T. for many years, looking after her through her childhood and
teenage years. She was now in her early twenties, and was going through an
alternate life style stage. She had become an urban hippy, and she dressed in loose
caftans, had long flowing hair, wore no makeup and lived with a group of like minded
people in an old house.
She presented to the surgery because she was very concerned about her heart.
For no apparent reason it would start racing, and the rapid heart rate would last
anything from a few seconds to a quarter of an hour before stopping. This would
happen every few days, and she didn’t like her body doing such strange things.
She denied any use of illegal drugs or alcohol, and when I examined her, the blood
pressure and pulse were normal. I suspected that she had paroxysmal atrial
tachycardia (PAT).
Paroxysmal means occurring suddenly and irregularly for no apparent reason. Atrial
refers to the atrium, which is the small upper chamber of the heart, and which
regulates the rate at which the heart beats. Tachycardia means "rapid heart" in Latin,
and indicates that the heart is beating far faster than it should.
Paroxysmal atrial tachycardia is therefore a sudden rapid beating of the heart,
which starts in the atrium. The diagnosis can be confirmed by performing an
electrocardiogram (ECG) while an attack is present, but this is often difficult to
arrange.
PAT is relatively common in women, may be triggered by hormonal, emotional or
other factors, and is not harmful. Most attacks last only a few minutes, and cause
minimal discomfort to the victim. The main problem is often the anxiety caused, as
many patients believe that they are having, or about to have, a heart attack.
If the attacks last for longer periods, or occur very frequently, medication can be
given to prevent them. The need for long term treatment depends on the severity
and frequency of attacks.
I started to reassure her that PAT was the most likely explanation for her problem,
but suggested that I should have a listen to her heart just to make sure it was
behaving properly.
She was wearing a loose caftan, tied at the waist with a woven rope belt, and the
broad neck was held on her shoulders by lacing at the front. She promptly undid the
lacing, and let the top of the caftan fall about her waist.
En route to examining her heart, my stethoscope wavered slightly from its direct
course to the appropriate area immediately below her left breast. It was impossible
not to note her breasts, or more precisely, the nipples.
Each nipple was pierced from side to side, and through the hole was looped a one
centimetre diameter gold ring. This in itself was extraordinarily unusual, but hanging
from each ring was a 15 centimetre long pink ribbon.
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