They say a picture is worth more than words.....

 Lots has happened since my last post. The heart is well and I'm feeling great. My wife did test positive for Covid. I tested negative but the whole house had to quarantine. Fortunately none of us got any sicker that a bad head cold.

Other than that nothing else special going on. We did have a nice Thanksgiving and we have done some hiking as a family as well as some solo hikes by myself. Also been hitting the trail with Larry. I've been averaging about 20 miles a week and doing no less than 5 miles at a time. the longest hike I've done so fare was a little over 9 miles.

Anyway here are some photos from the past month or so in no particular order. everything from hiking photos to physics problem solving examples I did for my son..

The Fam

Yellow Creek

Yellow Creek

Nice Buck

Smoked Turkakaunus

Physics

Classic

Market Square Ice Rink

Roaring Run

Larry (Roaring Run)

Whites Woods Par Course

Bear Run

Bear Run

Bear Run

There is so much more and I will share more later.........

Back From Austin

Had my 5th ablation this past Wednesday. Dr. Natale addressed the issues that were causing me issues.

My LAA had a reconnected circuit. He has worked my LAA 3 times now and hopefully this will be the last until I hopefully get a watchman down the road. My LAA is smaller than most so he has to address ablating it a different way than usual. There were also a couple smaller areas he addressed that fired off afib but weren't sustained.

Traveling during Covid is like taking part as an extra in some sort of weird Sci-fi movie. Where only a few people are aware of what's going on.It's easy to tell who those are as they are the ones wearing Tyvek suits and full head covering masks and rubber gloves. These folks also spend an abundance of time cleaning their gloved hands with hand sanitizer. While the rest of us are obviously ignorant to the situation that we find ourselves in.

Anyways, our trip home from Austin was pretty boring. Had a two hour layover in Atlanta and a 2 hour drive home from Pittsburgh international. So it was a long day to say the least. I did sleep really good last night though. Bed at around 11pm and out of bed @2pm today. I really needed it as I hadn't slept much since finishing up night shift Monday morning. Not counting surgery I was averaging about 4 hours a day this week.

Our stay in Austin was pleasant but shorter than normal. We stayed in the downtown this time. Things were pretty quiet there this time. I'm sure it was mostly due to Covid and the normal afternoon/evening crowds we are used to seeing are people leaving work and hanging out. Who aren't there now due to working form home. We did spend part of an afternoon on South Congress wondering through the small shops there.

I'm feeling really good today and looking forward to a week or so of just being. I can't express enough how appreciative I am of Dr. Natale and his team. As well as the staff at St David's. I really tried to convey that to everyone but still feel I need to do more

Still sluggish today. I can't say that I have ever felt the same following an ablation. Each time has its own little nuances.

One major difference this time around was my fitness level going into it. Not nearly as fit as I was back in 2009 but a far cry better than 2018 & 2019. Actually I would like to completely forget about 6 months worth of 2018 if it were at all possible.

Still sluggish today. Didn't sleep as well as I thought I would last night. Heart rate is rather low. Lingering between 54 and 64. I am currently only on Elequis and 25mg of metoprolol. I should be able to toss the metoprolol at the end of my blanking period so 3 months of governed heart rate which I am more than happy to deal with.

I'll try To Do Better

I'm really lacking at this blogging thing these days but I'm going to make an effort to improve.

Lots has happened since July. Besides Covid, shut downs, insanity, TP shortages, etc. Back in June I started having some off days on the bike. Heart rate seemed normal. However, I was unable to get my heart rate up over 132 a couple times when out. I chalked it up to the 25mg of metoprolol I take twice a day. But as the month progressed so did ectopic beats and a run or two of afb. Nothing while exercising though. It was always while just sitting around or when I first wake up. This went on throughout the entire month of June.

I spoke to Dr. Natale in early July and he put me back on flecanide for 10 days then wanted me to stop it after that again. Which I did. Once I stopped things seemed normal again and I got back to the bike. I also started paying attention to see if I could decipher what was going on or if I could pinpoint a trigger which if you have afib is like looking for a unicorn. Triggers are mostly non existent. And if you think you do have one figured out it will surely turn out to be that its not in most cases. There are a few out there though that will trigger an event.

I am about 99% convinced that other than the events I have when waking the others are most definitely triggered by eating. Not any particular food but how much and or how fast I eat. Since I have been watching these 2 things my episodes have disappeared for the most part. I'm still having ectopic beats and have had one really short run of arrhythmia on the bike the past week. I have an appointment early November with Dr Natale to hopefully finish off whatever else is lingering.

Riding & Hiking

Still riding, hiking and traveling on a pretty regular basis. As regular as working 7/7 schedule, with OT mixed in allows. As I mentioned above. I did experience a brief episode last Saturday towards the end of the ride. We had done allot of climbing including one ridge climb. This is the first time I allowed my Heart rate to go above 150 bpm. At about 3/4 to the top of the ridge I saw 173 and backed way off to not let it go any higher.

Towards the end of the ride I got split from the group as I hesitated at an intersection and had to wait on some traffic to pass. So I sprinted to catch up but still felt good at this point. A few miles down the road though my HR jumped to 188 bpm for about 10 seconds or so the right back to 149 bpm. Not sure if it was as short run of afib or a run of ectopic beats. My wahoo HRM just does HR nothing else. I felt fine the entire time and the remaining 5 miles were uneventful.

FORBES STATE FORREST

ALLEGHENY NATIONALL FORREST

NIAGRA

Bet You Didn't Know..........

Time flies

Its amazing how fast time goes by. I hadn't realized its been so long since I have posted here. But as they say no news is good news.

The heart has been ticking like clockwork. only the occasional epileptic. I have added D3 to my regiment and continuing to limit my calcium intake to see if that puts an end to those as well. I haven't been on the bike since September 2019. I have been having a hard time finding my way back to cycling since my last ablation. So much has happened along with time since I have been really regular with my cycling. I'm hoping that once the weather breaks the desire will come back.

I have been getting to the gym about 5 days a week though so I am getting good exercise. I am also doing allot of high rep sets and combining 2-3 exercises per muscle group. I'm avoiding any really heavy weights though as that is also tied to afib. The Gym is where my fitness addiction started so this is good.

Here is an example of what I am doing for my exercising. For chest my total reps need to be at least 60 total per exercise. I do 4 sets of 3 exercises. Bench Press-Dumbbell Fly's-Inclined Bench Press all done consecutively without rest in-between.

1st Set:
Bench Press : Olympic bar no weights 50 reps (warm-up) followed by 20 reps @135 lbs.
Dumbbell Fly's : 20 reps @25 lbs
Incline Press: 20 reps just using an Olympic Bar no weights (45 lbs)

I finish up by doing another 50 chest presses with just the Olympic bar. Today my total reps were Bench: 100 w/o weight and 65 @135 lbs. And 80 reps each Dumbbell Fly's and Incline Press.

I'm also dealing with a bad case of Bicep tendinitis. The doctor seams to think it will be ok in about 3 months. Someways I can barely lift my arm and other days it hardly bothers me at all. Surprisingly its not the gym days when it hurts the most. Its when I take a day or two off is when it really flares up. I have done some research and asked Dr. Google for some good ways to speed my recovery along. He suggested hanging from a bar my help and by golly it has.

Turns out Dr. Google has an associate shoulder surgeon that has allot of his patients try this passive exercise befog he will do surgery. You can read about it here. These guys also talk about it. They have allot of good videos covering a plethora of subjects. I'm amazed at  how much better my shoulder is compared to what it was before I started passive hanging. I hang for about 30 seconds between each set of exercises. I also hang at the end of a workout for 3/4 times for 30 seconds each.

All Gyms Aren't Created Equal

So we joined our current Gym a little over a year ago. The manager is a trainer that my wife used when we belonged to the local YMCA. It's in the basement of of a large office building. Its not fancy like the "Y". The equipment isn't new. But its a bona fide Gym. Those that know will know what I'm talking about.

I've belonged to several gyms in my lifetime as that is where my fitness addiction started. But non compare to RAT's Fitness Center that was located in the upstairs of a small office building in Vandergrift PA. The only other Gyms that even compare were  KFC (Kiski Fitness Center) and Robby Robs Gym which was formerly RAT's. The one thing these 3 all had in common was people that came to do one thing. And that one thing was to work out. They were all social to a point but only after the sweat started rolling. If you didn't get motivated in these places it was your own fault because the people working there and those who worked out there wanted to see you reach your goals and potential.

Our current Gym has that potential but its missing the key ingredient and that's Sammy Alberts and Robby Rob Robinson. Those 2 guys were motivators and allot of fun to be around as well. They could be serious but new when to lighten up.

 

Ablation Summary from July 2019

Back at the hotel after a fairly restful night.

Yesterday was a long day. Checked into St David's @ 0530. Was in the EP Lab @0600. As always the EP crew was upbeat and fun right up until the point I was out and woke to pleasant nurse in recovery. I really thought I would be able to get to sleep early last night but as usual that wasn't the case. I finally requested a sleep aid and was out shortly after.

My wait for a room was going to be a while so once I was fully awake she ordered me lunch and brought my family back to visit while I was waiting.
I can't say enough about the atmosphere at both TC&A or St. David's as the staffing is fabulous.

Dr Natale was very pleased with how things turned out. He confirmed all pulmonary veins were isolated from previous procedures. And successful isolation of posterior wall of the left atrium using roof and inferior posterior lines. He also ablated along the left atrial septum, floor of the left atrium, left atrial lateral wall and interior roof of the left atrium. He also isolated the coronary sinus and left atrial appendage.

For those that have been following along since last year you will remember that Dr Natale did work on my coronary sinus and LAA at that time as well. I also had an organic afib episode that originated in my LAA while he was working his craft on my coronary sinus. This was after he had already done some work on the LAA.

As you who are veterans to this process here will already know how difficult the LAA is to ablated due to its consistency and proximity to other vital organs. This limits the the time that he can spend there. So even though he had twice visited my LAA there was still a little work to be done.

Also, most benefit greatly from a single LAA procedure which may or may not completely isolate the LAA. The plus side to that is that not only does this eliminated Afib in some patients. It also increases the possibility that the LAA will still function properly eliminating the need for long term anticoagulants.

He did have some issues ablating my LAA as he normally uses a 15 mm lasso but it could not be engaged because the entrance to my laa is too small. So he just used the regular catheter and went into the left atrial appendage and isolated it that way by moving the the catheter around the interior.

When we talked this morning we went over everything that he did as well as possibilities for the future. Chances are at this point I will either be on long-term anticoagulants or we need to have the laa isolated with either of watchmen or a lariot sutcher approach. His concern at this point with a watchman would be sizing as there only two sizes and the fact that my laa entry is so small could be an issue. But that's all down the road.

He sent me home only on 25 mg metoprolol and 5mg Elequis twice a day. He does not want me taking the Flecainide unless I need it.

Back From Austin

WOW!!! I didn't realize I hadn't finished this post........ My Bad

Had another great trip to Austin and as usual TCA and St. David’s did not disappoint. My procedure last Thursday went off without a hitch and we had som good quality time in the city.

We left for the airport the night before our flight. The flight was early so we got a hotel with long term parking so we could get a good nights sleep and be able to do some site seeing the first day there. Unfortunately things didn’t work out quite as planned not a single one of us slept the entire night and our flight was at six, and the bus to the airport was at 4:30 AM.  So that was a complete bust.

We however did catch our flight without a hitch. Of course TSA had to give me a pat down obviously they don’t like cargo shorts. They also gave my wife a hassle for the sweater she had draped over her shoulders she had to go back and take it off and put it through the x-ray. My son had zero issues walked right through no questions asked. It was a far cry better from last year‘s fiasco so I’ll take it.  One thing I will say about the TSA on our flight home the TSA in Texas were much friendlier folk and what we experienced in Pittsburgh.

Our flight to Atlanta was good but of course Delta overbooked our flight from Atlanta to Texas and were asking for people to volunteer for a later flight. At this point we were still going to get to Austin before noon so the three of us decided that we would take the bump and the $200 per person comp. However, as time progressed and the need for more people to get off the plane we ended up with $400 a person so that was a pretty good payday.

We arrived in Austin around 11:30 AM and caught a Lyft to our hotel. I will say the hotel is pretty nice. It was located within walking distance of Saint Davids it would’ve been a nice launching point for some sightseeing if that was our only reason for being there. Whatever I have in my family with me I need to somewhere for them to be entertained and I thought they could use the pool. Unfortunately the pool in the photo didn’t quite match the pool in the  pool on the premises. It actually looked Olympic size in the pictures but more like a kiddy pool in person.  I explained the situation to the hotel clerk and she seemed fine with the fact that we did not want to stay there but we had a heckuva time finding an alternative.

After about an hour and several phone calls we did finally find a place that was only marginally more expensive but had a larger pool and a nicer room. So we caught a lift to that place and we all crashed. We all finally woke up around 10 o’clock which was too late to head to the city so we just decided to order in that night.

I had an appoint with Dr. Natale  the following morning so we got up early and headed to Saint Davids so I will be on time and had breakfast. But a half hour for my appointment We headed for Dr Natale’s office. I signed in and before I could get sat down they called me back to the room. I met with one of Dr Natale’s nurses and we went over all the issues I’ve been having this year lead me to be back to their office. Dr Natale soon showed up And we went over what he Expected to find the next day during the procedure and what he would be doing.

After the appointment we headed downtown and spent the rest the day there starting on SOCO and ending up at the bat bridge.

SOCO, otherwise known as South Congress is a very nice part of town. Lots of eclectic shops with good restaurants and music venues mixed in. You could easily spend the entire day just in this area.  One of my favorite stores on the street was Big Top candy.  They had every kind of candy that you could imagine.  Every variety of gummy you could think of and bins of chocolate covered everything by the scoop. Along with bottled sodas, hand dipped ice cream and milkshakes. Veritable sweet tooth heaven. For those of you into motorcycles I highly recommend revival cycles right across street from the candy store. Definitely another kind of candy for sure. Custom bikes clothing and parts galore.

After spending several hours on South Congress we ventured towards this city center. We started out this part of the journey with lunch at a Cuban restaurant. CUBA512 was the name of the restaurant and the service and food were outstanding.Once we finish lunch we walked up to the capital building and spent some time there. Following that we headed further into the city to what is known as the dirty six.  The dirty six is the oldest part of six street where lots of older restaurants and establishments are. This is also where the college students spend a lot of their time. Lots of bars and restaurants with live music. They also shut the street down traffic after 9 o’clock. I would also recommend this area for an evening Outing. We popped into a blues bar and listen to music for a while while we are waiting for a final destinations open. The Museum of the weird.

The museum of the weird is another one of those oddities in Austin. It’s a quirky little place with quirky employees but it was fun and worth the $36 tour. Lots of old movie wax figures and a little performance put on by the tour guide. After the museum tour we headed for the Bat Bridge.

The Bat bridge was a bust for us so I'll post this link to what we expected to see.
https://www.youtube.com/watch?v=YwWGvf38TVM

The Ablation the next day went off without a hitch. More work on my LAA and coronary sinus and that wrapped things up. We spent a couple more days hanging at the hotel then flew back to Pittsburgh.

We had a late flight out of Austin on Sunday so we headed back to SOCO for some Mexican food and some great Blues music. Guero's Taco Bar did not disappoint. I highly recommend if you are ever in town. https://gueros.com/#about