My Annual Check Up with My Local EP Was Fantastic!

Before I dive in I want to apologize for being absent for so long but I’ve been gone for a good reason. Life has been great! I still haven’t had a single episode of afib since my ablation in March 2015. That’s a little over 2 1/2 years now but who’s keeping track, right?

I also figured out (knock on wood) what was causing my constant PVCs and PACs so those have settled down greatly as well. On most days now my heart is completely calm and normal.

If you’re wondering why I keep referring to my doctor as my “local EP” it’s because the EP that did my ablation, Dr. Natale, is in Austin, TX. I live in a suburb of Minneapolis, MN. Dr. Natale is the only doctor I will allow to operate on my heart but I don’t go to him for my annual checkups for obvious reasons. I go to my local EP for those. I have my “expert ablation EP” and my “local EP.” I have a team of EPs:)

When I have my annual checkups I always have an echo done and then I meet with my doctor afterwards. This year’s appointment was about as smooth as can be and far less stressful than last year. When I had my appointment last year my PVCs and PACs were in full force and had been for several weeks leading up to the appointment. They were awful.

I was convinced the echo was going to reveal I had cardiomyopathy and that as a result I was going to need an ablation to nuke the PVCs and PACs. As usual, my mind got totally carried away. The EKG that was taken after the echo confirmed I was indeed having several PVCs and PACs (about every other beat was a PVC or PAC). Oddly enough, despite my rampant PVCs and PACs at the time, my echo showed my heart was perfectly normal and I had an injection fraction of 63%. That’s about as good as it gets!

Side Note: As scary as PVCs and PACs can be, and as awful as they can feel at times, in most cases they are totally benign and don’t cause any damage to the heart. I was having numerous PVCs and PACs for days and sometimes weeks on end and yet my echo showed my heart was perfectly normal and healthy!

This year my appointment was on Wednesday, September 27th, and it was totally different from last year’s appointment. My heart was totally calm this year during the appointment and for several days leading up to it. In fact part of me felt a little silly having a checkup because I felt so good.

My Echo

As I mentioned, every year when I have these checkups with my local EP I insist on having an echo. I do this for peace of mind. I know it’s complete overkill and totally unnecessary but an echo gives me peace of mind that nothing else can. Yes I trust my doctor when he tells me I’m fine but I want “scientific proof” to back that up. Only an echo can do that.

I talked to my EP about my insistence on having an echo done every year. I asked him if he thought it was silly. His response was reassuring. He said absolutely not. He said while it’s not common for patients to request an annual echo when there isn’t anything wrong, he fully supports my wishes to have one done every year.

He said as doctors there is more than one way to treat a patient. Doctors can operate, give prescriptions, offer advice, but one thing they can also offer is peace of mind, he said. And if that peace of mind comes from having a specific test done even if it really isn’t necessary, so be it. As he stated, providing a patient with peace of mind can go a long way in keeping a patient happy, healthy, and well. Is he a great doctor or what? I’m very fortunate to have him in my corner. I hope all of you have a doctor that is fully supportive of your wishes as it pertains to your healthcare!

O.K. getting back to the echo itself, like last year it came back perfectly normal. My doctor said there wasn’t anything he was concerned about. As always, I requested a copy of my echo report so I can keep track of any changes to my heart from one year to the next.

My ejection fraction this year was at 57%. I was a bit surprised at that because last year it was 63%. Anything over 50% is normal so I wasn’t worried about it. I was curious more than anything. My doctor said having an echo isn’t an exact science. There will be variances in the official findings based on the tech doing the echo, the equipment being used, the doctor doing the interpretation, etc. The bottom line for me was that my heart was perfectly healthy and he didn’t see any changes in my heart from last year to this year that concerned him at all.

My EKG, Resting Heart Rate, & Blood Pressure Readings

As I mentioned, last year when I had my EKG taken it showed numerous PVCs and PACs. This year the EKG revealed I was having only 1-2 PVCs or PACs every 10-12 heart beats. While you may think that’s still a lot, that’s very low for me and a huge improvement. I was actually surprised I was having any PVCs and PACs because I couldn’t feel any palpitations at all during the EKG.

The other thing that was surprising was my resting heart rate. I asked the tech who was taking my EKG what my resting heart rate was. I expected him to say something in the 60’s, which is what my resting heart rate was last year and what it was just a few months ago when I checked it. When he said it was 50 beats per minute I about fell off my chair.

I haven’t had a resting heart rate that low since before my ablation. I’ve always had a low resting heart rate because of all the running I did in my 20’s. My resting heart rate in my 20’s was in the low to mid 40’s. My dad used to always joke with me about that. He would always say, “How are you not dead with a resting heart rate that low?” In my 30’s my resting heart rate climbed to the lower 50’s where it stayed up until my ablation.

After my ablation my resting heart rate was in the mid 80’s and stayed there for over year. Now 2 ½ years after my ablation my resting heart rate is back to what it was prior to the ablation. I found it interesting (and surprising) that it took so long for it to return to my pre-ablation levels.

Side Note: If you’ve recently had an ablation or are considering having one done, it is totally normal for your resting heart rate to jump significantly and stay there for several months. The good news is you shouldn’t feel any different. When my heart rate went from the low 50’s prior to my ablation to the mid 80’s after my ablation, I felt exactly the same. Your heart rate will eventually settle back down but it may take several months or even a couple years. Don’t panic. This is all normal and part of the process!

My blood pressure was 110/64. As my doctors and nurses always tell me, that’s about as “perfect” blood pressure as you can get. Fortunately, I’ve never had problems with my blood pressure as it has always hovered around 110/60. It was good to know nothing has changed.

Talking Magnesium with My Doctor

After we got the echo and EKG and other vitals out of the way I had an interesting conversation with my doctor about magnesium. I told him I didn’t know what his stance was on the use of magnesium for afib but for me I think I finally figured something out.

For the past couple years I have had on and off battles with rampant PVCs and PACs. The one thing that was consistent during those struggles was my high levels of magnesium supplementation. I was taking anywhere from 600mg to sometimes as much as 1,000mg per day.

My thought process was simple; more was better (or so I thought). If my PVCs and PACs were bad, then I just wasn’t taking enough magnesium. When taking more didn’t help, I rationalized that they would be even worse if I decreased the amount of magnesium I was taking so I kept on taking high doses. Pretty stupid thinking, right?

Well it took me over two years to get smart. I fully admit I’m not the brightest bulb on the Christmas tree…lol. One day I just decided to stop taking magnesium for a while. Within a couple days my PVCs and PACs disappeared! I couldn’t believe it. All that time I was the primary reason my PVCs and PACs were so bad! You have no idea how stupid I felt but I was just glad I finally figured it out.

After about a week I slowly introduced magnesium back into my daily supplements but in very small amounts. Through experimentation I discovered my ideal daily intake is right around 300-400mg per day. If I take more than that my heart will be jumping around all over the place. If I stay within that range life is good

Side Note: I still strongly recommend magnesium supplements (specifically ReMag) for people with atrial fibrillation, PVCs, or PACs but you need to experiment with the doses. More is not always better! For some of you, high doses are going to work great. For others like me, it may require a lower dose. And not to complicate things even more, you might respond better to different types of magnesium. We are all unique so we might respond differently to the amount and type of magnesium. They key is to experiment and listen to your body!

Back to my magnesium conversation with my doctor…

He said it’s unfortunate we don’t have rigorous studies and peer-reviewed trials on magnesium like we do for various prescription drugs. He said a lot of what we know about supplements is anecdotal. He said if magnesium helps one of his patients with their atrial fibrillation that’s terrific. He’s totally supportive of it. However, he tends to shy away from recommending magnesium and other supplements as there just isn’t a lot of solid science behind them.

Understandably, his view point comes from being trained as an allopathic, or “traditional” doctor. Like most allopathic doctors, he wants to see randomized double-blind trials before he gets behind a certain type of drug, procedure, supplement, etc. No such trials exist for magnesium and there likely never will be so he’s reluctant to advise his patients to put a lot of stock in it or other supplements for that matter.

Having said that, he’s fully supportive of his patients trying supplements as long as they are safe – and magnesium is generally safe. He’s also willing to admit that magnesium and other supplements may in fact help. As a traditional doctor, however, (my words and not his), he’s not going to advise his patients to take X amount of magnesium or this or that supplement to treat their afib, PVCs, or PACs. Again, given his allopathic training I totally get it.

It was just an interesting conversation to have with him. It’s not often you get to have a philosophical discussion with your cardiologist about magnesium supplements and their role in treating patients. As we concluded our discussion he said he was happy to hear I was able to figure out a way to settle down my PVCs and PACs by simply reducing my magnesium. He wished me continued success with my new magnesium regimen.

Parting Thoughts

I can’t believe it’s been over 2 1/2 years now since my ablation. At times it feels so long ago and at other times it feels like it was just yesterday. I count my blessings and thank God every day for keeping me free of afib these past couple years. I pray that I’ll be blessed with many years of afib-freedom.

And even though I haven’t had to deal with afib in such a long time now, it still haunts me. A day doesn’t go by that I don’t wonder if today will be the day the beast returns. If it does, I pray that God gives me the strength and grace to deal with it and that like before he’ll bless me with another successful ablation!

One final note before I close, I know I haven’t written in a while but I still respond to every comment that is left on this blog and I get comments on a daily basis. Afibbers also contact me via email on a regular basis and I always reply to them. I’m still very much active behind the scenes of this blog so don’t let the fact that I don’t write that much make you think I’ve abandoned ship! I’ll always be here either writing or helping people behind the scenes.

I wish all of you well. God Bless!

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