Today, the Heart Rhythm Society is the recipient of a $10.00 donation from my family. If you would like to make a contribution to the Heart Rhythm Society, you can do so here:
Nine down, twenty-two to go.
Peace.
Showing posts with label AFib. Show all posts
Showing posts with label AFib. Show all posts
Wednesday, December 9, 2015
Causes and Effect, 12/9/15: Heart Rhythm Society
The ninth post of my month-long stint as writer of the Causes and Effect: My Year of Giving Daily blog can be found over at Tumblr. Here's the link to today's post:
Monday, November 9, 2015
Hearts Can Be So Fickle
It's been a little over a week since my last post here, which was about my recent "outbreak" of atrial fibrillation (AFib) and the troubles it was causing me. Today I'm here to give you an update.
I ended up taking the new medication (sotalol) for three full days: last Friday, Saturday, and Sunday. While I didn't have any more unexpected falls (thank God), I did have some side effects from the drug. To put it bluntly? It made me feel like shit.
The sotalol, like pretty much any drug designed to slow your heart rate down, made me feel incredibly tired. For three days I kind of felt like I was asleep even when I was awake, and that was no fun at all. I also had a few bad headaches. Not only that, but the medication didn't really slow my heart down that much. For the three days I was taking it, my heart rate pretty much hovered between 98 and 110. Prior to the AFib flare-ups, my heart rate was consistently between 55 and 65.
I could still feel the AFib coming and going, too. I would have little episodes, start feeling clammy, and find myself feeling out of breath after standing for long periods of time or going up stairs. Truth be told, I felt worse than I did when I was taking my old medication.
By late Sunday night, after three days' worth of the new medication, I had decided I had had enough and would go forward with the catheter ablation I had discussed with my electrophysiologist. I felt a great sense of relief and couldn't wait to call my doctor's office in the morning to let them know about my decision.
On Monday morning I called and talked to my doctor's nurse practitioner (NP). I explained how the sotalol had kicked my ass over the weekend and told her I wanted to schedule the ablation. She understood completely and we scheduled the procedure for Monday, November 16th.
The NP also told me to go back to my old meds--propafenone, along with a small nightly dose of digoxin--until the day of my procedure. Needless to say, I was more than happy to do that.
Then something strange happened. By late afternoon on Monday, I noticed that I was feeling better. Not just better because I wasn't experiencing the side effects from the sotalol anymore, but better because my heart felt like it was slowing back down to its normal rate again. And I didn't feel any AFib, either!
Tuesday morning I woke up feeling fine, and when my wife headed out to run some errands I asked her to pick up some prescriptions for me, including one for Xarelto, the blood thinner my doctor wanted me to take for the two weeks leading up to my ablation.
A short time later, my wife called me from the pharmacy. The Xarelto--a brand name drug with no generic available yet--was going to cost us $364.00. I was shocked. So shocked that I told my wife to hold off on picking that script up. I haven't had a full-time job in almost two years and money is kind of tight. Call me a cheapskate, but there was no way in hell I was going to pay that much for two weeks' worth of meds. I decided I'd call the doctor later on to see if there was a more economical substitute for the Xarelto.
But by Tuesday afternoon, I was still feeling better. In fact, I was feeling normal. So I held off on even calling the doctor's office. Instead, I figured I'd just see how I felt over the next few days.
Fast forward to today. More than a week after I went back to my old medication that didn't seem to be working anymore, I still feel normal. My heart rate is normal and I haven't had a single AFib flare-up.
Not one.
It's crazy.
So today I called my doctor's office, told them I was going to hold off on the ablation procedure for now, and made an appointment for a follow-up visit this Thursday. I don't know if my heart will continue to behave like it has been for the last eight days, but I'm more than willing to take a wait-and-see approach to find out.
The human heart is a complex machine, complete with an amazing electrical system that can, unfortunately, act up from time to time. I respect that and will keep a close eye on how my heart is doing over the next few days. I'm also anxious to hear what my doctor will have to say on Thursday.
It's nice to know that the catheter ablation procedure is in my back pocket in case I need it. But for now, I plan on sticking with the status quo until my body--or my cardiologist--tells me otherwise.
I ended up taking the new medication (sotalol) for three full days: last Friday, Saturday, and Sunday. While I didn't have any more unexpected falls (thank God), I did have some side effects from the drug. To put it bluntly? It made me feel like shit.
The sotalol, like pretty much any drug designed to slow your heart rate down, made me feel incredibly tired. For three days I kind of felt like I was asleep even when I was awake, and that was no fun at all. I also had a few bad headaches. Not only that, but the medication didn't really slow my heart down that much. For the three days I was taking it, my heart rate pretty much hovered between 98 and 110. Prior to the AFib flare-ups, my heart rate was consistently between 55 and 65.
I could still feel the AFib coming and going, too. I would have little episodes, start feeling clammy, and find myself feeling out of breath after standing for long periods of time or going up stairs. Truth be told, I felt worse than I did when I was taking my old medication.
By late Sunday night, after three days' worth of the new medication, I had decided I had had enough and would go forward with the catheter ablation I had discussed with my electrophysiologist. I felt a great sense of relief and couldn't wait to call my doctor's office in the morning to let them know about my decision.
On Monday morning I called and talked to my doctor's nurse practitioner (NP). I explained how the sotalol had kicked my ass over the weekend and told her I wanted to schedule the ablation. She understood completely and we scheduled the procedure for Monday, November 16th.
The NP also told me to go back to my old meds--propafenone, along with a small nightly dose of digoxin--until the day of my procedure. Needless to say, I was more than happy to do that.
Then something strange happened. By late afternoon on Monday, I noticed that I was feeling better. Not just better because I wasn't experiencing the side effects from the sotalol anymore, but better because my heart felt like it was slowing back down to its normal rate again. And I didn't feel any AFib, either!
Tuesday morning I woke up feeling fine, and when my wife headed out to run some errands I asked her to pick up some prescriptions for me, including one for Xarelto, the blood thinner my doctor wanted me to take for the two weeks leading up to my ablation.
A short time later, my wife called me from the pharmacy. The Xarelto--a brand name drug with no generic available yet--was going to cost us $364.00. I was shocked. So shocked that I told my wife to hold off on picking that script up. I haven't had a full-time job in almost two years and money is kind of tight. Call me a cheapskate, but there was no way in hell I was going to pay that much for two weeks' worth of meds. I decided I'd call the doctor later on to see if there was a more economical substitute for the Xarelto.
But by Tuesday afternoon, I was still feeling better. In fact, I was feeling normal. So I held off on even calling the doctor's office. Instead, I figured I'd just see how I felt over the next few days.
Fast forward to today. More than a week after I went back to my old medication that didn't seem to be working anymore, I still feel normal. My heart rate is normal and I haven't had a single AFib flare-up.
Not one.
It's crazy.
So today I called my doctor's office, told them I was going to hold off on the ablation procedure for now, and made an appointment for a follow-up visit this Thursday. I don't know if my heart will continue to behave like it has been for the last eight days, but I'm more than willing to take a wait-and-see approach to find out.
The human heart is a complex machine, complete with an amazing electrical system that can, unfortunately, act up from time to time. I respect that and will keep a close eye on how my heart is doing over the next few days. I'm also anxious to hear what my doctor will have to say on Thursday.
It's nice to know that the catheter ablation procedure is in my back pocket in case I need it. But for now, I plan on sticking with the status quo until my body--or my cardiologist--tells me otherwise.
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| Things have been pretty normal around here lately. |
Friday, October 30, 2015
Of Irregular Heart Beats and Vulnerability
Something happened last night that scared the hell out of me.
I woke up in the middle of the night and had to go to the bathroom. That, in and of itself, was not scary. As a slightly-beyond-middle-aged male, I've grown kind of accustomed to that annoying trip to the bathroom every night. But what happened once I got to the bathroom was something I'd never done before.
I fell.
When I had gotten out of bed moments earlier, I felt that rush of blood to the head one sometimes feels when getting up suddenly from a resting state. I didn't think much of it, but when I walked into the bathroom it felt like I was walking into a carnival funhouse. I lost my balance, my vision went fuzzy, and the next thing I knew I was falling. And I couldn't stop.
I ended up on the tile floor after bouncing off the bathroom vanity first, and in the process sent the bathroom scale flying. I think I screamed, too. In fact, I must have screamed, because before I knew it, my wife was in the bathroom asking me what had happened and offering her assistance.
I had fallen, and I couldn't get up.
Now, before you all start thinking to yourselves, "Damn, this guy is old," let me tell you that I believe last night's incident was the result of my having started taking a new heart medication yesterday. (Damn...I am old.)
I was diagnosed with atrial fibrillation (AFib) almost 18 years ago. After several episodes of a rapid, fluttering heartbeat--think fish flopping around in your chest--and a trip to the emergency room, doctors were finally able to figure out what was wrong with me. They put me under for 30 seconds (literally), used those cardioversion paddles you always see on TV to shock my heart back into a normal rhythm (CLEAR!!!), and all was good again. The same medication has kept my heart pretty normal ever since. But, unfortunately, sometimes meds stop working.
Almost three weeks ago, I started having AFib flare-ups with some regularity. In fact, I've probably had more flare-ups in the past three weeks than I'd had in the previous 18 years. And it kind of sucks.
For those of you who don't know, atrial fibrillation is an abnormal heart rhythm characterized by rapid, skipping, quivering beats. While my normal heart rate is around 60 beats per minute, during an AFib episode that number can go up to 125, 140, or even higher. (During hospital stays early on, I saw my heart rate rise to 300 bpm and beyond.)
The crazy heartbeat is caused by abnormal electrical signals in the heart. If you were to look at a handout in a cardiologist's office, it would probably say stuff like, "The top and bottom parts of the heart don't work together as they should"; "The heart beats very fast and irregularly"; and maybe "As a result, blood is not properly pumped to the bottom part of the heart and the rest of the body." All of this ends up causing some nasty symptoms--dizziness, light-headedness, shortness of breath, confusion, massive fatigue, chest pressure or pain, sweating, etc.--and, if not controlled, an increased risk of stroke and heart failure.
So thanks to AFib, I've had the best damn cardiologist you could ask for since the relatively young age of 36. (He's actually a "cardiac electrophysiologist," in case you want to get technical.) And yesterday I went to see him about my most recent flare-ups.
He told me he suspected that the drug I started taking 18 years ago (propafenone) had become ineffective, and gave me two options:
1.) I could try another drug (sotalol), and see how it worked for me.
2.) I could have a procedure known as a catheter ablation.
Basically, a catheter ablation involves a thin, flexible, tube with an electrode at the tip of it being inserted through a large vein in your groin and moved into your heart. The catheter is then directed to the precise location(s) in your heart that are producing the AFib. These points are then burned off by zapping them with the electrode. Fun stuff, huh?
As complicated as that procedure may sound, for someone who knows what they're doing, it's relatively simple. And the success rates are pretty high. Of course, there are the normal risks associated with someone putting you under anesthesia and burning off parts of your heart with a wire they stuck into one of your bigger veins. But, all in all, it's pretty straightforward.
To be perfectly honest, I went into my appointment yesterday ready to lobby hard for the ablation procedure. It's been a long time since AFib has kicked my ass like it has this month, and getting refamiliarized with everything the surprise flare-ups entail reminded me just how shitty the symptoms can be. Plus, I wanted nothing to do with trying any new medications. Why? Because the medications that help regulate abnormal heart rhythms come with side effects, the most annoying one being fatigue. When you slow down someone's heart with meds, they're going to be tired. Period.
After talking to my doctor for a bit, my wife and I finally asked him, "If it were you, what would you do?" His answer? Try the new medication first. Initially, I was disappointed to hear this, but his explanation made total sense. If the new meds work without making me feel awful, it's a win. And if they don't work--or if they work and make me feel miserable in the process--I can always go the ablation route.
So that's where I'm at. I took my first dose of the new medication last night, just a few hours before I ended up on the bathroom floor. I took my second dose this morning, and while I feel a little "off," at least I'm managing to stay relatively upright.
The last few weeks--especially last night--have really made me stop and realize just how vulnerable we are as human beings. Or at least how vulnerable I am. Life is a gift, there's no doubt about it. And the older I get, the more I understand that it's a gift with an expiration date.
Falling in the bathroom made me think of my dad, too.
In the months leading up to his death, my dad fell in his bathroom on two different occasions, and I was the person my mom called to come over and help him up. (I talk about one of those incidents here.) Both times, I was struck by how helpless my dad was in that moment. It was terrifying and sad. But you know what? That was me last night: sitting on the bathroom floor, in the dark, wondering what the fuck had just happened, as my wife stood over me asking how she could help. I am 32 years younger than my dad was, but still in the same scary, vulnerable position.
Sotalol and I are not off to a very good start, but I'll keep taking the new medication for the next couple of weeks and monitor how my body reacts to it. If everything goes splendidly, maybe I'll choose to continue with that course of treatment. But if there are any hiccups along the way--or any more unplanned trips to any floors--you can bet I'll be turning my abnormal heart beat over to my cardiologist and his heart zapping electrode.
"When we were children, we used to think that when we were grown-up we would no longer be vulnerable. But to grow up is to accept vulnerability....To be alive is to be vulnerable." --Madeleine L'Engle
I woke up in the middle of the night and had to go to the bathroom. That, in and of itself, was not scary. As a slightly-beyond-middle-aged male, I've grown kind of accustomed to that annoying trip to the bathroom every night. But what happened once I got to the bathroom was something I'd never done before.
I fell.
When I had gotten out of bed moments earlier, I felt that rush of blood to the head one sometimes feels when getting up suddenly from a resting state. I didn't think much of it, but when I walked into the bathroom it felt like I was walking into a carnival funhouse. I lost my balance, my vision went fuzzy, and the next thing I knew I was falling. And I couldn't stop.
I ended up on the tile floor after bouncing off the bathroom vanity first, and in the process sent the bathroom scale flying. I think I screamed, too. In fact, I must have screamed, because before I knew it, my wife was in the bathroom asking me what had happened and offering her assistance.
I had fallen, and I couldn't get up.
Now, before you all start thinking to yourselves, "Damn, this guy is old," let me tell you that I believe last night's incident was the result of my having started taking a new heart medication yesterday. (Damn...I am old.)
I was diagnosed with atrial fibrillation (AFib) almost 18 years ago. After several episodes of a rapid, fluttering heartbeat--think fish flopping around in your chest--and a trip to the emergency room, doctors were finally able to figure out what was wrong with me. They put me under for 30 seconds (literally), used those cardioversion paddles you always see on TV to shock my heart back into a normal rhythm (CLEAR!!!), and all was good again. The same medication has kept my heart pretty normal ever since. But, unfortunately, sometimes meds stop working.
Almost three weeks ago, I started having AFib flare-ups with some regularity. In fact, I've probably had more flare-ups in the past three weeks than I'd had in the previous 18 years. And it kind of sucks.
For those of you who don't know, atrial fibrillation is an abnormal heart rhythm characterized by rapid, skipping, quivering beats. While my normal heart rate is around 60 beats per minute, during an AFib episode that number can go up to 125, 140, or even higher. (During hospital stays early on, I saw my heart rate rise to 300 bpm and beyond.)
The crazy heartbeat is caused by abnormal electrical signals in the heart. If you were to look at a handout in a cardiologist's office, it would probably say stuff like, "The top and bottom parts of the heart don't work together as they should"; "The heart beats very fast and irregularly"; and maybe "As a result, blood is not properly pumped to the bottom part of the heart and the rest of the body." All of this ends up causing some nasty symptoms--dizziness, light-headedness, shortness of breath, confusion, massive fatigue, chest pressure or pain, sweating, etc.--and, if not controlled, an increased risk of stroke and heart failure.
So thanks to AFib, I've had the best damn cardiologist you could ask for since the relatively young age of 36. (He's actually a "cardiac electrophysiologist," in case you want to get technical.) And yesterday I went to see him about my most recent flare-ups.
He told me he suspected that the drug I started taking 18 years ago (propafenone) had become ineffective, and gave me two options:
1.) I could try another drug (sotalol), and see how it worked for me.
2.) I could have a procedure known as a catheter ablation.
Basically, a catheter ablation involves a thin, flexible, tube with an electrode at the tip of it being inserted through a large vein in your groin and moved into your heart. The catheter is then directed to the precise location(s) in your heart that are producing the AFib. These points are then burned off by zapping them with the electrode. Fun stuff, huh?
As complicated as that procedure may sound, for someone who knows what they're doing, it's relatively simple. And the success rates are pretty high. Of course, there are the normal risks associated with someone putting you under anesthesia and burning off parts of your heart with a wire they stuck into one of your bigger veins. But, all in all, it's pretty straightforward.
To be perfectly honest, I went into my appointment yesterday ready to lobby hard for the ablation procedure. It's been a long time since AFib has kicked my ass like it has this month, and getting refamiliarized with everything the surprise flare-ups entail reminded me just how shitty the symptoms can be. Plus, I wanted nothing to do with trying any new medications. Why? Because the medications that help regulate abnormal heart rhythms come with side effects, the most annoying one being fatigue. When you slow down someone's heart with meds, they're going to be tired. Period.
After talking to my doctor for a bit, my wife and I finally asked him, "If it were you, what would you do?" His answer? Try the new medication first. Initially, I was disappointed to hear this, but his explanation made total sense. If the new meds work without making me feel awful, it's a win. And if they don't work--or if they work and make me feel miserable in the process--I can always go the ablation route.
So that's where I'm at. I took my first dose of the new medication last night, just a few hours before I ended up on the bathroom floor. I took my second dose this morning, and while I feel a little "off," at least I'm managing to stay relatively upright.
The last few weeks--especially last night--have really made me stop and realize just how vulnerable we are as human beings. Or at least how vulnerable I am. Life is a gift, there's no doubt about it. And the older I get, the more I understand that it's a gift with an expiration date.
Falling in the bathroom made me think of my dad, too.
In the months leading up to his death, my dad fell in his bathroom on two different occasions, and I was the person my mom called to come over and help him up. (I talk about one of those incidents here.) Both times, I was struck by how helpless my dad was in that moment. It was terrifying and sad. But you know what? That was me last night: sitting on the bathroom floor, in the dark, wondering what the fuck had just happened, as my wife stood over me asking how she could help. I am 32 years younger than my dad was, but still in the same scary, vulnerable position.
Sotalol and I are not off to a very good start, but I'll keep taking the new medication for the next couple of weeks and monitor how my body reacts to it. If everything goes splendidly, maybe I'll choose to continue with that course of treatment. But if there are any hiccups along the way--or any more unplanned trips to any floors--you can bet I'll be turning my abnormal heart beat over to my cardiologist and his heart zapping electrode.
"When we were children, we used to think that when we were grown-up we would no longer be vulnerable. But to grow up is to accept vulnerability....To be alive is to be vulnerable." --Madeleine L'Engle
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| Dr. Luis Pires: The best cardiologist on the planet and the best doctor I've ever had. |
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