What an interesting day yesterday. I had my initial consult with Dr. Natale down in Austin, TX nine days ago. I’ll be publishing a blog post about my appointment soon. I’ve been really busy so I haven’t had a chance to get to it yet but I will soon (hopefully in the next few days). I’ll give you a hint…Dr. Natale is going to do my ablation!
I didn’t hear from his scheduling office until yesterday afternoon. I had a handful of dates to choose from in January and February and ultimately I decided on February 2nd. As soon as I locked in the date I was feeling really unsure about the whole thing.
I hadn’t had an episode in over two weeks – and the last episode I had was a “minor” one compared to previous episodes. I was honestly feeling like an ablation was overkill at this time. I convinced myself that I wasn’t going to have an episode until I had my ablation.
The exact thoughts in my head were, “Now watch. I won’t have a single episode now until I have my ablation and I’ll be second guessing this decision the rest of my life.” Then my second thought was, “I hope I have at least one more episode before the ablation to remind myself why I’m having this ablation.”
Well as the saying goes, God works in mysterious ways. Just five hours after committing to having an ablation in February, I went into afib! What are the odds of that?
It was 7:50 p.m. and I was sitting on the couch (not lying down) playing Madden on the Xbox with my son. It was 4th down and 15 to go and my team had the ball. I decided to go for a first down instead of punting and I got sacked for a five-yard loss. I leaned forward very quickly and jokingly screamed at my team for giving up the sack. I want to put the emphasis on joking. I wasn’t stressed at all nor was I seriously mad. Both my son and I were laughing. That quick movement forward and the vocal burst set my heart off.
I knew instantly I was in afib but I kept playing for another five minute or so. I got up and grabbed my AliveCor heart monitor to confirm what I already knew:
At 8 p.m. I took my 300mg of Flecainide and decided to work on my computer. I find it’s easier for me to get through these episodes if I stand so I worked at my standing computer desk. I was hoping it was going to be a quick and pleasant episode like my last one but no such luck.
This baby went on for exactly 3 ½ hours. I didn’t fully convert until 11:20 p.m. I always wait a little bit before taking my EKG as I want to be sure I’m 100% done with my episode. Here was my reading at 11:33 p.m:
While it wasn’t pleasant, this episode wasn’t that bad at all. In fact I kept up my usual routines and just acted as if I wasn’t in afib. Aside from a few brief moments of feeling slightly faint (mostly when walking upstairs or downstairs), it was totally bearable throughout the night. It was an annoyance more than anything.
There was something interesting that happened, however. Right when I converted at 11:20 p.m. I had this sudden intense “faint” feeling, and my fish-flopping heart and everything around me paused and the room went black for a millisecond. I’ve experienced this before when I’ve taken Flecainide. Every time I’ve had this strange experience I’ve converted to NSR seconds later. I can only guess what’s going on is a chemical cardioversion. The drug is essentially “kicking in” and converting my heart to NSR.
While I wasn’t exactly thrilled to have another afib episode, I was thankful that I had one because it reinforced my decision to move forward with an ablation. Thanks for the sign, God!
Possible Triggers
I don’t even know why I bother to figure out my triggers because it doesn’t seem to matter. Even when I think I’ve identified a pattern, I’m proven wrong but it’s fun so let’s do it anyway!
Let’s start with one of the usual triggers I think plays a role – sleep. I will admit, today I woke up feeling a different kind of tired. It’s hard to describe but some days I wake up with this kind of “sickly” tired feeling. That’s what I had today. In some of my previous episodes I had this same kind of tired feeling when first waking up in the morning.
Now let’s move on to the next suspect trigger – food. I theorized in some of my previous episodes that a dinner heavy in carbs might play a role. Tonight I didn’t have a “carb heavy” dinner but I did eat slightly more than I should have at dinner. I had two whole-grain hard shell tacos and that was it. Normally I would only have one taco, but even with the two tacos my total calories were only around 500 calories. These were not spicy tacos either so that wasn’t it. Looking back at my previous episodes I did find one where I had eaten two soft shell tacos for a total of 600 calories at dinner. Is there a connection? Possibly…but unlikely;)
The immediate trigger for this episode was the sudden movement forward and me screaming. Now I know what you’re thinking. I had an episode not too long ago where screaming at my monitor immediately triggered an episode. It’s easy to say, “STOP YELLING,” and maybe you won’t have as many episodes…except it’s not that easy.
I don’t want to come across as a guy that is constantly yelling but I do have a tendency to yell from time-to-time. I should be able to yell without going into afib. That isn’t exactly normal. While stressing out (for real or for fun in this case) may be an immediate trigger, there is obviously some underlying factor at play here.
As you can see, there comes a time in your atrial fibrillation journey where figuring out a trigger becomes a moot point. As afib progresses, I don’t think there are any specific triggers. You’re just going to have episodes randomly and there is nothing you can do to prevent them.
Hi, Travis
Just wanted to let you know I had my ablation procedure Nov 20, and it was successful! The procedure took 7 hours. I was in the hospital that day and the next day until about 6 pm. Thought I’d mention a few things I experienced that were surprising. After 7 hours under anesthesia, I had a very sore throat, dry mouth, lung pain, gas and nausea. I had a really rough night in the hospital, and wished I’d had another pain pill. (only one was prescribed, so all I got after that was Tylenol.) What was surprising was that these symptoms continued for at least a week. I feel normal now after 2-1/2 weeks. In the hospital, my nurse was concerned about my chest pain, until she consulted a another nurse, who told her my chest pain was from the trauma of the procedure. It lasted about a week,: it hurt to take a big breath, or walk. The gas also lasted a week, and the sore throat longer. I’ve also had three episodes of rapid heart rate–but not AFIB–since the procedure. After the first two, I contacted my surgeon, who said to expect palpitations,
So if I knew now what I didn’t know then, I’d ask for more and longer pain control.
Other than that, so far so good. I wish you the best in your AFIB Journey, and I hope it ends soon! Kay
Kay:
Congrats on the success of your catheter ablation! That’s so awesome to hear. I love hearing about success stories. I wish you continued NSR and I hope your afib is history for a loooong time.
Thanks for the heads up on what I might expect. I don’t do pain very well at all so your comments freak me out…lol. I’m just trying not to think about it for now. To be honest what keeps me from freaking out about the pain is I look to my son for strength. He had his tonsils removed this fall and he was in probably the worst pain you can be in. I figure if a 7 year-old can endure pain, so can I:)
I’m surprised how long your procedure took. My EP says it will be around a 2 hour procedure assuming everything goes according to plan. Did you have any complications during your procedure? And it sounds like this was your second ablation, is that correct? If so, how long ago did you have your first one?
Travis
Crazy Travis how frequent your episodes have become in such a short time, I am curious if you read anything regarding the Hybrid procedure which is gaining a lot of attention in the success rates and is still minimally invasive, there are a number of discussions on various forms of social media I have been reading regarding this although I really do not know specifics on who does it and any pros and cons versus the standard catheter ablation procedure. http://adventistheart.org/livecast/?id=stopafib
Ryan:
Tell me about it! How the heck do I go for 7+ years with only an episode maybe once a year to having them almost weekly now? What could possibly change that much in my body??? I’m dumb founded and just slightly pissed off!
I’m vaguely familiar with the hybrid maze procedure. It’s one step up from the usual catheter ablation in terms of surgical procedures for afib. From what I’ve read (and have been told), usually people don’t consider other procedures like the hybrid maze unless the first ablation or two don’t work – especially in “simple” cases like mine (younger guy, no health issues, paroxysmal afib). Now if my case was more complex, a simple ablation might not be the route. An EP might recommend going straight to the hybrid maze or something similar.
When I brought up these other procedures with an EP here locally in Minneapolis, he laughed. He said I’m no where near that – yet. He said it would be best to try an ablation first and if that doesn’t work, then consider more complex, invasive procedures.
Thanks for the link to the webinar. I wonder if they recorded it since the date it was held has passed. I’d like to watch it if they did but I couldn’t find anything.
Travis