Don’t ignore your symptoms

When my symptoms began, I dismissed them. Stress, I thought. Something I ate. Even when my episodes became more frequent, I was cavalier about seeing my doctor. I could almost certainly have avoided my trips to the emergency room if I had paid attention to my symptoms and taken action sooner. If you have symptoms, don’t wait. See your doctor as soon as possible and get a diagnosis. Not only can the symptoms of atrial fibrillation be associated with more serious health issues, but leaving your atrial fibrillation untreated can make you more susceptible to future episodes.

If you don’t know what’s going on in your body, it’s better to be safe than sorry. See your doctor.

Doctors are not the final answer

While I have the utmost respect for my doctors, I quickly came to the conclusion that they couldn’t be the last word on my condition. Doctors have a natural bias toward pharmaceutical and surgical interventions and little knowledge or enthusiasm for alternatives. Listen to your physician, but don’t let them prevent you from exploring other options.

Take responsibility for your own health

This follows from the last point. Your doctor knows a lot, but it’s your life. Ultimately, you will have the make the decisions about your treatment and live with the consequences of your choices. There are many options that are worth exploring that your doctor won’t tell you about. I quickly learned that if I didn’t want to take drugs or entertain the possibility of an ablation (a medical procedure that destroys areas of the heart responsible for causing abnormal heartbeats), I would be on my own. I pursued other methods for managing my atrial fibrillation and that’s how I found the most relief.

Avoid drugs whenever possible

I’m not advocating that you ignore your doctor’s advice, but always ask if there are other options. Almost all (if not all) drugs have potential side effects (many vitamins, herbs, and supplements can have side effects, too). Many of these effects are not fully understood when drugs are prescribed (consider the case of Fosamax, an osteoporosis drug now linked to atrial fibrillation). Once you begin taking medications, you’re on a slippery slope. Many people take medications to manage the effects of other medications they’re taking.

As soon as I began taking Diltiazem, I began the search in earnest for alternative treatments; I didn’t like the way the drug made me feel. If you haven’t started taking drugs yet, and your doctor says it’s okay to wait, explore your alternatives first. If you’re already taking medication, ask your doctor if the alternatives you’re considering are safe. If they are, try them. If they help, ask your doctor about reducing or eliminating your medications.

Absence of evidence is not evidence of absence

One reason your doctor is unlikely to be supportive if you want to try alternatives to conventional treatment is that most vitamins, herbs, and other supplements have not been extensively researched. Most physicians practice evidence-based medicine; they’re reluctant to prescribe something that doesn’t have validation from controlled studies. Ignoring the fact that much of this research is itself questionable, and that the main reason there is a dearth of research on non-pharmaceutical alternatives is because they can’t be patented, keep in mind that the absence of evidence is not evidence of absence, i.e., just because something isn’t proven to work doesn’t mean that it doesn’t work.

If you ask your doctor about a supplement, they’re likely to respond with, “There’s no evidence for that, but if you think it helps, it’s okay.” I’ve had three doctors tell me this almost word-for-word. If they don’t tell you outright that something you want to try is harmful, or interacts with medication you’re already taking, don’t be afraid to experiment. No one knows everything.

Treat the whole body, not the parts

Doctors like to break the body down into its constituent parts. If you talk to a cardiologist, he’s narrowly focused on the heart. Specialization is great—I don’t want my family doctor doing open heart surgery—but it also has it’s limits. Your cardiologist may not know anything about nutrition, for example. If you have other symptoms, he may not know if—or how—they relate to your atrial fibrillation. There’s no question in my mind that improving your health generally will improve your atrial fibrillation. Don’t be narrowly focused on treating your symptoms; take the initiative to do everything you can to become more healthy.

Start with your diet

The first thing I learned when I saw the cardiologist in the hospital was that my diet was a likely culprit in my atrial fibrillation attacks. I was dehydrated, had low potassium, and high blood sugar. When I got home, I read the packages of my recent diet of frozen pizzas, chips and salsa, cereals and ice cream. All of these processed foods were extremely high in sodium (which depletes potassium, necessary for healthy heart function), high in simple carbohydrates (which raises blood sugar, a risk factor for atrial fibrillation), and inflammatory (which may have contributed to my pericarditis, which exacerbated my atrial fibrillation).

One of the healthiest things you can do is eat a healthier diet. Change your diet, change your life.

Everyone is different

A medication, vitamin, or herb that works for someone else may or may not work for you. The same is true for other alternative treatments. I have a brother who can interrupt his episodes by bending over and bearing down as if he’s going to the bathroom. I’ve tried it; it didn’t work for me.

This principle applies to diet and nutrition, too. While there are general guidelines for healthy eating that apply to almost everyone (eat less, eat more fruits and vegetables), your constitution and current state of health requires a diet tailored to you. The principle is called bio-individuality. You’re unique.

How do you know, then, what’s right for you?

Learn to really listen to your body

Pay attention to your body. You don’t have to become a hypochondriac, just become intimately familiar with how your body feels and what makes you feel better or worse.

For example, I noticed that I felt worse at night if I slept on my left side. I later read that this is a common experience for people with atrial fibrillation. So I tried sleeping on my right side. Sure enough, that felt better. I also noticed that I felt worse if I stuffed myself at dinner, especially if I ate later in the evening. Again, I’ve since read that this is also a fairly common experience. I now try to eat dinner around 6:00 PM and to stop when I’m comfortably full.

I took this a step further and bought a stethoscope and began listening to my heart when I was relaxed and in normal sinus rhythm. Later, when I was having symptoms, I would sometimes listen to my heart with the stethoscope and remember what my heart sounded like when things were normal. I found it surprisingly comforting.

Go slowly and keep things simple

Try everything, but do one thing at a time and pay careful attention to your body. Your body is your lab. Experiment and notice what works or doesn’t work. It’s a good idea to take notes. Track how you’re feeling, what you’re doing when you experience symptoms, what you’ve been eating and what supplements you’ve been taking.

If you try supplements, try one new supplement at a time, take a small dose and slowly increase it to the recommended dose. If you’re desperate for help, then try several things and, if you begin feeling better, cut back on them one by one. Notice the effect on your body.

I’m a big believer in taking vitamins, herbs, and other supplements, but I’m not big on taking more than necessary. These substances can also have side effects or deleterious effects that are not well known. Some of them may be useless and a waste of money.

Don’t be afraid to try different options. Keep learning.

Status: Draft. Last edit: 05.27.08