Turning Point?

Maybe anyway.....

Following my last post I had a run of 32 hours in NSR. Then into affib which only took 4 hours to convert back to NSR. Since that conversion I have been in NSR without a blip.

So as of now I have been in NSR for almost 48 hours. Needless to say my attitude is much improved. It's amazing what a normal heartbeat can do for your psyche. I'm not so naive to think that I will stay in rhythm all the time but this is a far cry better than it has been for sure.

The Grind......

Otherwise known as work isn't so bad. I have a good counterpart in the control room. We get along well and he is a wealth of knowledge. The rest of our crew is outstanding as well. We are a pretty cohesive group all in all and have zero qualms about helping each other out so nobody gets left out in the cold.

We currently have a Control Room Trainee on our shift right now. Unfortunately he does not mesh with the crew. He had asked me before taking the job if I thought he could do it. I have no doubt he can but he has a long way to go to gain the respect of everyone.

He has an issue with work and already has a reputation as being lazy. And that does not go over well when you are asking people to do work for you. He is also the type of person that needs constant reassurance, or in his own words needs to have his ego stroked, which can be pretty annoying at times. He's got a long row to hoe for sure.

Frustration.....

So it's been a week since I left the hospital and I am in rhythm about as much as I am out of rhythm. the longest I have gone in NSR so far is 28 hours. The shortest period of time it has taken me convert back to NSR is about 10 hours. So one migh argue that the Ticosyn is working, moderately at least. But quite frankly I'm really starting to get frustrated.

The other issue is when I am out of rhythm I take 75mg of metoprplol which really nocks me down. The 50mg I take daily nock's the snot out of me as it is. The whole thing has becom quite debilitating and depressing. It completely limits my activity and keeps me from doing th things I enjoy.

Back In The Saddle....

Got home from the hospital on Saturday afternoon and headed straight for the bike and a nice easy 20 mile ride. What a positive affect getting out in the fresh air doing something you enjoy has on your perspective. I made sure to keep my heart rate at a manageable level and just enjoy the moment.

I did the same thing on Sunday. The weather was not nearly as nice being about 20 degrees cooler but all in all a nice ride. Up until the point my heart went into affib again. It appears that my heart has gone back to its old ways by triggering the affib at low resting heart rates and recovering heart rates.

I went in to affib about 2 miles from the house. All I had left in the ride was a nice easy down hill then a decent climb before another flat stretch to home.I was just starting the downhill watching my heart rate. When my rate reduced to 85 bpm it converted to affib and shot up to 199 bpm. it then fluctuated between 199 and 100 for a while then settled in at around 150 bpm.

My heart converted back to NSR yesterday morning but went back out again just a short while ago. So we will see how long it takes me to convert back to NSR again.

That's a Relief....

Spoke with my Doctor yesterday afternoon. He called to follow up with me on my hospital stay and also my recent affib episodes. He let me know that he had spoken to his associate and that he was totally fine with me seeking out a second opinion. We had a really nice conversation and he offered up his assistance in any way he could to help me find a solution. He thought that my choice of surgeons I had chosen was top notch and referred to him as a Guru.

I actually spoke with that doctors office today and the process for seeing him is underway. They already received some of my medical records and the rest are in process for them to receive. So hopefully that will all work out and I will be going to see him. I will write more about that ast the situation progresses.

Failure.......

Well, not a complete failure. At lest not yet anyway. 

Last night when the nurse brought my evening meds. And probably about the time Brit Floyd was finishing up their first set, I went directly into affib. My heart rate was between the mid 90's  adn 150's. They called the doc and he had them give me another 25mg of metoprolol. This brought my heart down to around 105 bpm at thee high range, which he, and most importantly I could live with without concern to doing any damage to my heart. I think I mentioned that during my cardioversion TEE that it appeared that my heart may have weakened a little bit. Nothing it wont bounce back from but still not a place I want to go. 

So the options this morning were to either stay here and start another medication or go home on the Ticosyn and see how it goes. Knowing that I could still go into affib. On anecdotal note here is that yesterday for my morning meds I also to Singulair which I use for exercise induced asthma. Was this the cause for the breakthrough last night? Lord only knows. I did however communicate with a fellow affibber today and they said it took a good 3-4 weeks for the Tikosyn to fully take hold.

So now I sit here waiting on my wife to find her way to pick me up.

Breaking Up Is Hard To Do......

Like I said before one of my doctors associates was in this morning to talk to me. During our  conversation I mentioned that I had contacted Dr Andrea Natale concerning my condition. I wanted to bring this up with my regular EP but I really like the guy and I know he is doing everything within his power to help me. His partner was totally respectful of me being open and understood completely why I had such a hard time bringing this up to my regular doc. We covered some other options and his opinions on those and their success factors. He was going to talk to my doc about my current situation as well as what we talked about concerning Dr Natele.

Even though I was just speaking to one of his associates I still had that it's not you its me approach which we both laughed about. It's amazing the relationship that can be formed between a caregiver and patient. That is one of my concerns about maybe having him do another procedure. I don't want him doing or trying something he has not tried before or at the very least 100 times trying to fix teh problem.

It's A Beautiful Thing

So I started the Tikosyn yesterday morning @0900 and converted to NSR @1210. So I guess that means the medicine is going to work. For how long nobody can say. They started me out with 500 Micrograms/2x but cut me back to 250 Micrograms/2x as my QT intervals were getting too far apart. So two more days and I can get out of this place. The weather is starting to turn and I want to ride my bike.

It's been a while since I've ridden medicated. Last time I did it was back in 2009. We did a Century that day back in March of 2010. Not only was I medicated that particular day I was also wearing and event monitor. So we will see how it goes.

The Eagle Has Landed......

Back in the hospital. It was planned of course but was planning on getting here early and started on my new meds. Well I got here early but the meds aren't going to arrive until tomorrow morning. Seems I was more ready for them than them for me.

I have always lived by the creed that no good deed goes unpunished. A good Preacher friend of mine told me that a long time ago and I have found it to be true. Just like there is no such thing as gaining brownie points with your wife. The all equal a zero sum gain and usually lead to a loss.

Anyway, the good deed was for me to have my wife just bring me early this morning and drop me at the door. That way she could get on with her day as she had a pretty full schedule. And as you read from my opening paragraph I pretty much spent most of the day moving from one comfy chair to the next with the occasional stop by the cafeteria mixed in.

So tomorrow I will start on the Ticosyn and hopefully be out of here by Friday night to go see Brit Floyd.

Current State.....

Friday's activities definitely took their toll on me. I felt pretty tired that day but yesterday kicked my a$$. Got home from work and had a bite to eat. Hit the shower and in bed by 7pm. Of course that meant that I was awake by 1230am and have been up ever since.

I usually take melatonin when I want a good long sleep but was so tired I figured I would not need it. I should have known better. I do feel better than yesterday but its early yet. 12 hour days can take a toll on you, especially when your down already.

I was supposed to give Zwack a call last night to fill him on all the details form Friday but was too tired to even do that. I'll ring him tonight.

That Wasn't So Bad

I had my Cardioversion done yesterday morning so my day started at around 0345 as UPMC Shadyside is about an hour  adn a half away and I needed to be there by 0600. So we got on the road a little after 0400 and arrived at around 0530. Had X-rays done then headed to the short stay unit right outside the Cath-Lab as my procedure was scheduled for 0800.

The procedure would start with a TEE then the electricity would flow shortly after that to place my heart back into NSR. Sounds simple enough right? I have never had a bad experience at this hospital and it would turn out that this day would be no different. The nurses came for me just before 0800 to wheel me into the lab. As we entered the lab I was met with smiling faces and an upbeat vibe.

The Lab Nurses started right away both prepping me and comforting me. The Anesthesiologist and Nurse Anesthetist followed not too far behind as well as my Cardiologist. I haven't been to see him in over 9 years but has stayed in contact through my Electrophisiologist. We had a brief conversation about how long we had known each other. I started seeing him when I was 23yo. Lets just say its been pretty much a lifetime at this point. He would be performing the TEE prior to the Cardioversion.

The room was a buzz with activity with everyone talking to me, letting me know what was going on and what to expect. One thing I noticed, and I have noticed this before, is that when anyone person in the room was talking directly to me and within arms length they placed their hand on me. This is really a nice touch IMHO, it gives you a feeling of connection between you and them. Now I have no idea if this is a part of their training or if it is just a natural reaction that those in the medical field have.

My EP then entered the room and it was game time. The Nurse Anesthetis asked me one more time what my weight was? I asked if she wanted real time weight or ideal/goal weight? Everyone laughed then it was time for the TEE which I actually despise and this time would be no different. A TEE (Transesophageal Echocardiography) is done prior to proceedures pertaining to the heart to look for any formation of blood clots on the back side of the heart. It aslo gives a look at the fuction of the heart. The one thing they did see is that it appears that  being in flutter for over a week may have done some short term damage to the heart. No diferent than if you would overuse any other muscle in your body. So all should return to normal on that particular front.

The Anesthesiologist said he would start administering the sedative and as soon as I started to swallow the probe he would give me more and I would not feel any discomfort. Major fail here folks. As I was trying to swallow and gag on the probe I was wondering what he considered to be discomfort because I was definitely feeling some at this point. At some point at this juncture I remember hearing a nurse yelling at him if he was going to administer the drug as I was obviously in distress at this point. He said he was then it was lights out. I woke up some time after that, everyone was gone, and I was back in wonderful NSR. They monitored me for a time then sent me back to the short say unit to continue monitoring me for a couple hours then I was home bound.

What' Next?

The current plan is to start me on a new drug to keep in in NSR as the Flecanide does not seem to be doing the trick. The new med I will be on for now is Ticosyn. It is another antirhithmic drug that will hopefully keep my heart in NSR while waiting for the next step. In order to take this drug I need to be off of the Flecanide for a few days then back in the hospital for a few more while they start the new one. I will have to have an EKG done every two hours as the new drug is administered for several days to be sure I can tolerate it. So as of today I am off the Flecanide and still in NSR. I will be keeping my activity level at a minimum for a few days to try to keep it that way as the concensus seems to be that the ablation in January did not completely solve the problem and the Cardioversion is only a temporary fix and there is no way of telling how long my heart will stay in NSR.

I have also started the process to see Dr Andrea Natele in Texas to do my next and what I hope to be my last Ablation. He is a pioneer in this procedure and one of  the top worldwide so needless to say I am excited to have the opporatunity. It is going to be a process but well worth the effort in the end.

Confirmation

Received confirmation today for my cardioversion this Friday. I need to be at the hospital @6am and the procedure is scheduled for 8am. As of now the plan is to have me back home later that day. There is only a slight chance that they will keep me and that only depends on weather or not they decide to change my antiarrhythmic drugs.

I'm not thrilled about changing my meds even less the aspect of being on them in the first place. The whole idea of this was to be completely med free as I was back in 2009 and I will continue to seek that end.

Ugh......

So as of tomorrow I will have been out of rhythm for a week. To say I'm disappointed would be an understatement, and until you have spent even 1 hour out of NSR thee is absolutely no way that you could ever understand. I emailed my doctor on Friday concerning the next step and possible cardioversion and I just got off of the phone with him a while ago. I was contacted by a nurse later today and scheduled the cardioversion for this coming Friday. This will involve me having another TEE and then electrically converting my heart back to NSR. None of this sounds like very much fun, however I am determined to get ahead of this and finally slay my demon.

After the cardioversion I will continue on the Flecanide. There is a possibility I will be changed to a new drug Tikosyn which I don't think will be an option I am personally wanting to take. The change would require a 4 day stay in the hospital to be monitored 24/7 and the medication itself is not a path I want to take.

There Is A Bright Side

Over the weekend I reached out to fellow affibers as to the process to seeing a Specialist in another state. I got lots of feedback immediately which did not surprise me in the least. There is a specialist I have known about for a while now and had the situation been different back in January  is who I would have liked to have don my second ablation.. Things moved pretty quickly that day and having had good success the first time around I had little doubt that the touch up procedure would be any less effective. Again Ill mention that wonderful thing called NSR that a majority of folks live with every day and the desire to achieve that for myself again.

So know I have wheels set into motion on two fronts. The cardioversion and the process of having the specialist have a go at my heart. I will be sure to keep a good record of what is to come so as to maybe help somebody else down the road.