2 Cardioversions in 2-1/2 weeks

[DeltaDawn23]

I guess I don't have a question, just venting.  I am just back from my 2nd cardioversion in 2-1/2 weeks and am somewhat discouraged.  They were able to get me back to normal rhythm and increased my Norpace CR at least until I see the cardiolgist on January 7.  I am having to take 1-1/2 to 2 Atentolol tablets to keep my heart rate down -- usually I take 1/2 to 1 a day.  My TEE at first conversion showed severe bilaterial dilation, which I will discuss with the cardio also, as it was mild in April.  I am just hoping the cardioversion will hold until I can get in to see the doctor.  I am jumping at every little heart skip and praying that I can stay in normal rhythm.  At least this time I didn't have to have the TEE.  The staff was very nice altho I had to wait all day for the conversion.  My diabetic husband was starving and dehydrated by the time we got out of there, I am grateful I got in before the holiday weekend and I did not have to go thru the ER to get converted.  The EP nurse called and got me a slot to come in and bypass the ER.  I guess I just need to realize that this is pretty much out of my hands and I will have to deal with whatever comes, when it happens.  

[MaryLL]

I say trust your instincts. If this doesn't feel right, don't do it but it sounds like you're already good at scoping things out. Sorry about the stomach upset too. Fortunately, I finished my medications yesterday and I have to say I feel generally better. Even though I was on anti-nausea meds, I was throwing up alot. Everything tastes off, even water, right now!
I see the cardiologist on Monday and I hope he puts me on some stopgap meds for the last 2 months of my 3-month surgery healing time. I haven't been on anything for 2 weeks and it scares me.
I had to smile at your "I Love Lucy" spaceouts. Mine are "Everybody Loves Raymond" and/or "The Golden Girls." I agree with you, sometimes it's just all too much to even think about.
So it sounds like you are generally still feeling lousy, though you are getting through it as we do. I'm sorry you're so uncomfortable and hope that some decision is made and it is one that makes your life better soon. I keep you in my thoughts and prayers and appreciate you and your sharing.
healing hugs your way!

[DeltaDawn23]

Meant to say I was taking my leftover 12 hr. drug every 8 hours.  Also,I mean  I Love Lucy.

[DeltaDawn23]

I am so glad you are doing better.  That 8.1 Warfarin level is scary.  Can they give you some vitamin K?  Did they have you stop your dose for now?  It can be very difficult to keep between that 2-3.  Mine went up twice over meds -- once is was Zantac, which the nurse swore would not do it, and another time is was pepto bismo, which apparently is full of asprin.  Some of your meds may have caused it.  I have a meter and can check mine at home, which is kind of nice.  It's a Phillips meter -- you might ask about it.  My insurance pays for it.   The study my EP is pushing is the CABANA Study (Catheter Ablation versus Antiarrhythmic Drug Therapy for atrial fibrillation trial).   Basically, the computer decides which you get, a drug or an ablation.  I was offered something similar when I had breast cancer and I declined.  I was disappointed at the small amount of information they gave me -- just a slim little brochure along with a poorly copied sheet, and a patient consent sample -- for another study!  I was not impressed.  I am feeling a little better.  I just went on my new dose with a 12 hours med, before I was just using up what I had and taking it every 12 hours.  It overlapped and I think that was causing some problems.  I am having digestive issues and each time I recently went into afib it was after I had eaten and had stomach upset.  So I may need to go back to my dr. re my acid reflux.  I've been taking Zantac instead of Prevacid, but lately having some problems again.  All of this thinking makes my head want to explode:P  I need to veg out and watch old I Love Lucky re-runs or some other mindless activity:)  Will be keeping you also in my thoughts and prayers.  Sending healing alpha waves your way.  I will look for your post also.  It is so helpful to have someone know how this feels.

[MaryLL]

You have alot to consider here. I was glad to read that you take your time, collecting information, in making decisions. Making decisions when you're in the midst of it is almost impossible, I think. My head feels fuzzy and seeing things clearly is elusive.
The cell training sounds interesting. I will look forward to hearing more from you on the study. I'm glad you have the PCP to rely on and trust his judgment. We really need to be able to talk frankly with our caregivers and have them give us the best information they have available.
Today is my last day on antibiotics and my coughing is much much better. The nausea is still a problem but I am out of diuretics and suspect they might have made nausea worse. My warfarin levels shot up to 8.1 (normal 2-3), so I am avoiding knives, tripping, etc. which is hard for a klutz! I am going in now to have them rechecked and hopefully, they have come down.
Have to go, thinking of you and keeping you in my thoughts and prayers. Please keep me posted!

[DeltaDawn23]

I understood what you meant.  Any thoughts on this study I'm being encouraged to consider?  I will have more details in a day or 2 and will share them.  My last appt. my EP was adamant that I get off the anti-arrythmic, and wouldn't even discuss ablation.  Now, he seems gung-ho on this study and is pushing ablation.  No thoughts or discussion on changing or increasing meds further.  During the appt. he mentioned the study 3 times.  It's a little off-putting.  I made an appt. today with the 2nd opinion EP at the U of M -- they have a huge new cardiovascular center that is really quite impressive and are doing some research (training regular cells to replace the misfiring ones) on arrythmias that will hopefully be of help to patients like us in the future.  Trouble is I can't get in until 3/21.  But I am on the cancellation list and the scheduler said if I did go into afib to call and they might get me in.  So I could go in and see if this other EP has an opinion on all this.  The smaller hospital I go to is more personal in some ways, but I am not feeling like my case is really getting a good rview.  I am also calling my pcp and asking him to review my medication to see if anything I'm taking might have caused this, and I will ask his opinion on the ablation option.  He is a really nice fellow and I rely heavily on his judgement.  I am not one to make decisions overnite or lightly.  I am going to need some time to get my head around this ablation thing.  I'm considering it, but switching gears is going to take a little time.  It's always been my way to gather all the info I can, find the best people I can and then go with what they suggest.  So I hope I can do this while in nsr, rather than having to make decisions while my heart rates is rocketing around.  Thanks for your comments, keeping me in your thoughts and in advance for any suggestions.  Hope you are doing well -- how goes it?

[MaryLL]

I just reread my first line, I didn't mean I was disappointed "with you". I meant I was disappointed too in what the doctor had to say and do.
Hope you are hanging in there, you're not alone even though I know it feels that way.
sending hugs, hopes, and caring,
XXXX

[MaryLL]

Well, I am disappointed with you. It seems like he just reiterated what he had said before, then postponed tests 3 months, and threw more medication at you. I also encourage you to get a second opinion. There seem to be several schools of thought about a-fib and the one you have doesn't seem especially compatible with your own attitude, hopes, and willingness to try new things.
I'm probably a poor poster child for ablation as they didn't work with me, but I do know MANY people whose lives are significantly improved by ablations. Enough that it was worth it for me to try 3 times.
We've talked alot on here about making decisions and where to go, what to do next. Yes, a-fib requires alot of patience, but it also requires taking action when it's time and finding medical providers who are willing to go there with us. I am one month out from the surgical ablation tomorrow and still in NSR. The pneumonia has been hell but heart has been good.
You're the best, and I know you will make the right decision for you. But again, I encourage you to talk to someone else since it doesn't seem like you are getting the information you need from your current doctor.
Sending hugs, prayers, good thoughts, and anti-a-fib energy!

[xxDoylexx]

Cardiac enlargement, left atria is common for afib patience if you have had it for a while, I am in that club.  If you have been on meds for a while, find a EP who does ablations.  If you have insurance it is worth the try.  The procedure while long, is physically very easy with no pain at all.  Recovery is just a couple of days, for the procedure. I don't know where you live but, I would look up someone who has experience doing ablations.

Listen I was in afib 30 to 50 percent of the time, maybe more.  Now, my a-fib is better, not gone but far less occurring.

Good luck and Id wouldn't wait the three months for the next test.  I would find someone who will deal with it this week.  

[DeltaDawn23]

As to "waiting around" I think I'm suffering with the delusion that this is more under my control than it actually is.  Perhaps I'm learning patience?

[DeltaDawn23]

Saw the EP today.  I am somewhat disappointed -- guess I wanted him to reassure me, pull some magical rabbit out of his bag.  He says the severely dialated atria is typical for anyone in afib and it may shrink back down.  He says an ablation is still possible, odds to be calculated more when I have an echo in 3 months and we see how much the atria has shrunk, if any.  He's pushing for me to join a study.  The computer chooses meds or ablation and from this they will learn what is the best treatment.  Apparently it is being done all over the country -- I am waiting for the info in the mail.  I'm definitely going to go for a 2nd opinion.  He left my meds at a higher dose and I spent a couple of hours on the phone to the pharmacy, drug ins. carrier and dr's office finding out the pharmacy doesn't have what I need in a generic, so it's going to cost me -- but that was not a surprise, just a pain to do the pharmacy's work for them:P  I guess I had set a lot of store in this appt. and basically, nothing's changed, I'm just hanging in there waiting to see what will happen and hoping for the best.  Kind of bummed.  I want to be more pro-active and get something done.  Seems wrong to wait around for whatever fate is going to toss at me.  Anyway, that's all I know.

[gothic_beauty]

I know exactly what it is like not to feel quite a part of the world. When my heart rhythms were at their craziest, I didn't leave my house. Unfortunately, that was during the summer instead of now, when it is so cold outside that staying in wouldn't seem quite so bad! It is great that you have been in normal rhythm for a little while at least. Good luck with the doctor tomorrow. Fingers crossed that he/she will be able to help.

[DeltaDawn23]

Hey -- I had my nose pressed against the (cold) windowpane looking out on the world I don't quite feel la part of at this point.  I see the doctor in the morning, planning my shower, etc. tonite so I don't get overtired in the a.m.  Life seems very complicated when you never know if your heart is going to turn it all upside down and everything but heart issues go on the back burner.  I so appreciate your support.  It is hard for people not experiencing these issues to realize how incapacitating heart rhythm issues can be.  I'm 10 days out from my last cardioversion and holding in nsr so far.  I had a couple of hours of skipped beats today that settled down when I took my meds.  I am hopeful the doctor can get to the bottom of these recent episodes and adjust my meds to keep me in nsr.  I guess the answer is just to take it day by day. Happy New Year to you with wishes for a heart-issue-free year for all us heart rhythm folks.  Thanks again for your support.  It truly makes a difference and makes me feel less alone.  

[gothic_beauty]

Hey DeltaDawn ...

I just wanted to add my voice to those of the other members who support you, and to tell you how sorry I am that you continue to struggle with AFib. I've never experienced that particular problem, but I deal with very high heart rates and irregular rhythms that are terrifying to me, so I know what it is like to be constantly preoccupied with one's heart. However, you sound as if you are hanging in there, both mentally and physically. You are so brave. Congratulations on your amazing steadfastness in dealing with this issue. Don't forget to keep us posted with how you are doing, as I will be thinking of you often. Happy New Year and have a great day :)

[DeltaDawn23]

I agree the TEE is simply a diagnostic test, altho the anesthetic left me with an upset stomach.  You might have to decide which is the worst of the two evils -- going without alcohol or chancing afib.  I have had to give up carbonated drinks, chocolate, travel and many activities I enjoy -- but I would do almost anything to avoid another afib episode.    Good luck to you -- keep us posted.

[MaryLL]

I agree with Jerry, if alcohol is worsening your a-fib, then alcohol is out. Have you been to a sober support group or thought about intensive inpatient or outpatient treatment? I'm sure your doctor would refer you as there are large health issues involved. Quitting drinking is hard to do but with support, you can do it.
Your life is worth it. Wishing you the best.
Happy New Year,
MaryLL

[Jerry_NJ]

I have no understanding of how a TEE could cause you any problems, it is it doesn't require any cutting, every think is sent down through open passages and then sound waves are sent through your chest to view your heart (right?).

What could go wrong with that and what does that have to do with binge drinking?

Happily I was only a occasional binge drinker and that all ended by age 30.  I do enjoy a few drinks in a social situation, but no drinking to get drunk.

Happy New Year and drink less, or if that is not possible, don't drink at all, you, your heart, and those around you will all be much better off.

[gonefishin65]

one more thing, watch out if you check yourself into the ER, they'll trap you there trying to chemically convert you back to sinus rythym, which doesn't work if you have tachycardia, my heart is beating at 130-140 BPM...but still, these idiots charged me $30,000 in ICU for 5 days before finally agreeing to the TEE after I begged my cardiologist to intervene...Watch out if you have good insurance!  I went in on a Friday to give blood for my Monday outpatient TEE, and they said they couldn't let me go as I could die, and I was stuck in the ICU (nice room, nice nurses, they kiss your ***), but still I just wanted the outpatient TEE and then get the heck out of there and sweat it out at home...This last TEE procedure a month ago was for tachycardia, which I had never had before, I always had arrythmia with a slow pulse, and this was really was hard on my heart, and I never recovered.  How do you talk a reluctant cardiologist into one more TEE?  I know he thinks I got drunk this time again, but I swear I didn't...I am scared straight I think!  Next time I get really smashed it will be the last time as I don't think I will survive it...I have no problem drinking 10-15 beers and some shots - I have a sickness, and smoke, and party....Well, I'm almost 48 and it's getting old.  Yea I love to drink, but all good things must come to an end eventually...Anyone else with a booze problem - good luck.  

[gonefishin65]

just had a TEE december 4rth 2012 and had problems right off the bat...my 4rth TEE since 2007, and all successful except I drank my guts out, and at random times I would go AFIB.  My cardiologist said if I drank again he'd discharge me.  I am in tachycardia again, and my cardiologist suggested ablation and referred me to another cardiologist in his group.  I really don't know what to do...I would prefer one more shot at TEE because after this last one I didn't exercise as it was really cold, and I didn't let my heart recover.  I usually walk 3-4 miles daily.  I walked 4 miles 2 nights ago and lost control of my heart rythym.  I didn't drink at all...I guess I can never drink again, that's the hardest part of all of this...It's too unpredictable, I could drink a lot and never had a relapse, but all it takes is one binge episode too many, and whoom, back into AFIB...Honestly, after all my TEE's I never had any problems whatsoever and felt like a million bucks...NOT THIS TIME!  

[MaryLL]

No enlargement of the atria. Aside from the afib my heart has been normal. I've had afib for 14 years and until the two years, it was pretty much contained by medication. Maybe a once a year hospitalization. After my first ablation in 2010, it was more frequent, then I had two more ablations and it was worse each time until I was having weekly episodes. ALL MY DOCTORS say this is rare and ablations generally help or they don't, but rarely make things worse.
I am counting with you. I think a second opinion is important. Due to insurance issues, I changed 2 years ago, and then asked for a second opinion after the last ablation. The doctor I was referred to is one of the best cardiac thoracic surgeons, and he was good.
Sending thoughts and prayers and holding you in my little afibish heart!

[DeltaDawn23]

Thank you all for your support and kind words.  It helps.  I am now 2-1/2 days and counting.  If I can stay in NSR until I see the EP, at least I can discuss my options.  Thinking of looking into a 2nd opinion again.  I would like to avoid being in the position of having to make decisions in an hurry.  I am heartened and uplifted by all your positive thoughts.  Jerry, I think dialation and enlargement may be the same thing, but not sure.  The stopafib.com website had a video about afib and the possible progression and steps to treat it on their end-of-the-year most watched videos.  Mary, how many years have you had afib?  Did you have enlargement/dialation of the atria?  I don't know if that rules out an ablation or thorascopic surgery or not.  Michelle, thank you again for your upbeat thoughts and the hugs:)  I was blindsided by this whole thing, because I just had an appt. in October with the EP and everything seemed fine -- he was even talking about taking me off the meds.  Back to the drawing board.  I'll let you know the outcome of my appt.  Thanks again.

[MaryLL]

I am so sorry to hear you've been dealing with this. I know how upsetting, anxiety-producing and just plain exhausting it is. The month before my mini-maze I went in 4 times in 5 weeks to be cardioverted. The health care system I have has an Urgent Care where you can go right in and be cardioverted, so the ER stuff can be bypassed. Waiting all day in the ER is enough to cause a meltdown by the end of the day!
I hope the increase in medication can keep you in NSR and that is isn't causing too much fatigue.
I am with you in spirit, and keeping you in my thoughts and prayers. I really do wish a calmer a-fib year for all of us.
Bless you Deltadawn!

[Jerry_NJ]

I don't know the difference between dilation in the heart verses enlargement.  I will assume enlargement is more "permanent".  I had a left atrium enlargement to the extent that I underwent mitral valve repair, the cause of the enlargement.  The surgeon said it could shrink back some, even at the age of 67 at that time.

My left atrium has not shrunk, but it is no longer (5 years) getting larger, it is stable.

Another difference in my experience is my cardio and the EP gave up on electrocardioversion, I think because of the enlarged left atrium, when the last one held for only a week.  I had hope that the atrium would shrink and I'd have an argument to try a cardioversion again.  

My EP and the supporting hospital has streamlined electrocardio versions of the years I've used it.  In the beginning I had to check into the "same day" center where I was prepared for conversion.  After a hour or two (approximately, I had an appointment) I was rolled into the surgery/whatever room and converted.  The last time I skipped the "same day" center, going directly to the ICU where (I must have changed into a "gown/robe" I went directly onto the conversion bed.  When done I got up and went home, my wife driving the car as I was not allowed but am sure I could have done it.

Happy New Year and fewer episodes please.

[MichelleP_3811]

Yes, unfortunately some things are out of our control.  Hopefully now that you are in NSR your heart will recoup and your dialation will go down.  Hearts do have an amazing ability to heal themselves though it can take a while so just take it slow for now.  Stay strong.  I send good thoughts your way.  (((HUGS)))