My Second A-Fib Ablation Experience

As usual, this is a very long blog post detailing as much as I can about my second a-fib ablation experience. In case you’re wondering why my blog posts are so detailed, I do it for two reasons. One, this blog is my way of journaling my a-fib journey. I want as many details documented so I can look back on them if necessary. Second, I want to share all the details of my journey with you so that you might learn something that might be helpful to know for your own a-fib journey.

Feel free to read the blog post in its entirety, or use the table of contents below to click to any section that strikes your fancy. Enjoy!

The Day Before the Ablation (January 18th)

I got a call from St. David’s the afternoon before my ablation that I had to be at the hospital at 7:00 am. I immediately knew that meant I wasn’t going to be the first procedure of the day so I was a little bummed. When I had my first ablation back in 2015, I was the first procedure of the day and I had to be there at 5:30 am.

It doesn’t really matter when your procedure is in the scheme of things but the main advantage of being the first one of the day is there is zero wait time and virtually zero chance of your procedure being delayed.

If you’re procedure number two or three or four of the day, your wait time will be longer and there is a decent chance your procedure will be delayed due to procedures before you taking longer than expected. It can quickly be a domino effect. If the first procedure takes longer than expected, then every procedure after that will be delayed.

Even though I was fortunate enough to be at least second up for the day, I was still fully prepared for at least a three hour wait. I figured the best-case scenario was I would be in the EP lab around 10:00 am.

I slept about two hours the night before the procedure. I have struggled with insomnia for years so I don’t sleep much to begin with, but whenever I have something big going on the next day I don’t even know why I bother to even try to sleep.

I went to sleep at midnight and woke up at 2:00 am and couldn’t get back to sleep. I sat up in bed and browsed the news and watched some TV shows on my iPad until 6:00 am. I got up, got dressed, and popped my 5mg of Eliquis. I couldn’t eat or drink anything so I was ready to go within a couple of minutes. I patiently waited for my wife and daughter to get dressed and to get ready to go so they could take me to the hospital.

You’ll notice I had to take a 5mg dose of Eliquis at 6:00 am the morning of my ablation. This is their continuous anticoagulation protocol. The protocol is to keep your blood anticoagulated at all times, even during the procedure.

During the ablation they are constantly monitoring the active clotting times of your blood to ensure it remains in a certain range. By keeping your blood properly anticoagulated throughout the procedure, you prevent the risk of stroke during the procedure. Before this protocol was developed several years ago, there was a much higher risk of stroke during the ablation. Now that risk has virtually been eliminated due to this protocol.

Getting Prepped the Morning of the Ablation (January 19th)

We were staying in a vacation rental just five miles from the hospital so we got there in no time. We officially arrived at 6:30 am. I had some miscellaneous paperwork to fill out and then a brief wait and by 6:50 am we were being led to the prep room by a nurse named, Peter.

In the prep room I had to fully undress and get into my hospital gown. All my vitals were taken, and an EKG was taken. I was in normal sinus rhythm with a resting heart rate of 55. After that I had a few more papers to fill out and sign and then an IV pick was put in my arm.

At around 7:45 am I told my wife and daughter that they were free to go. There was no sense for them to sit around in the prep room with me as it would likely be a few hours before it was my turn.

A Brief Pre-Ablation Visit with Dr. Natale

About fifteen minutes after they left Dr. Natale dropped by. While I was pleasantly surprised to see him, I couldn’t help but wonder how long my wait was going to be if he hadn’t even started his first ablation for the day. At least that’s what I assumed was the case since it was only about 8am.

We exchanged pleasantries and shook hands and then he said he was hoping he wouldn’t have to ablate the LAA given my age. What he meant by that is if you have your LAA ablated, most people will need to be on a blood thinner for life or will need the Watchman device implanted. He was hoping to spare me either option given I was only 50 years of age.

I jokingly replied (but seriously meant it) that as long as I was there having another ablation, I’d prefer he just ablate the LAA and get it over with so I don’t have to deal with it down the road. He laughed and said he totally understood, but he said he would let the EP study guide his decision on what gets ablated. As he said, “we’ll see what happens once you get in there!” (as in get in the EP lab).

When Dr. Natale does an ablation, the first part of the procedure is the EP study where the heart is fully mapped and the sources of a-fib are identified. The second half of the procedure is the actual ablation. The EP study essentially guides him as to what areas of the heart need to be ablated. The EP study and the ablation are done in the EP lab, or EP room.

As he left, he said I was his second procedure of the day so it shouldn’t be too long before I would be in the EP lab. It was a brief visit, but a visit much appreciated as I wasn’t expecting to see him at all until after my ablation. I thought it was a nice gesture that he took the time to stop by and say hi before my procedure, especially given how busy he is. I’ve been told that he does anywhere from 3-5 ablations a day on those days he does ablations!

Getting Shaved Down Before the Ablation

Not long after Dr. Natale left another nurse named A.J. came in to shave me down. This was new to me because I don’t remember getting shaved when I had my first ablation. They had to have shaved me back then, but I have no recollection of it. Maybe I shaved myself before I went to the hospital? I don’t recall.

As a man, getting shaved down by another man is an interesting experience. Fortunately, A.J. was a cool guy and made what could have been a very awkward situation totally fine. He was a family man like me and was just a few years older than me, so we had a lot in common.

It turns out he also loved the 80’s just as much as I did. We reminisced about life in the 80’s and exchanged our favorite 80’s music and movies while he proceeded to shave my entire chest, stomach, groin area, and upper legs. After A.J. was done shaving me down he wished me well and left the room.

Constant Urge to Pee Before the Ablation

I got up and went to the bathroom for the hundredth time. I couldn’t stop going to the bathroom. Since I woke up at 2:00 am I had been going to the bathroom literally every ninety minutes or so like clockwork. I couldn’t stop going.

I’m sure my nerves, adrenaline, anxiety, etc. were getting the best of me. Whatever it was I was starting to freak out because I kept wondering what was going to happen when they put me to sleep for my ablation. Was I going to pee all over the place in the middle of the procedure…lol?

When I got back from my ninetieth trip to the bathroom another nurse named Clay came in to grab my clothes and overnight bag. He said he was taking all of my belongings to my recovery room. He said they would be waiting for me there after my procedure. About fifteen minutes after that he returned to tell me it was time to head to the EP lab. It was my turn!

The Ablation Begins

It was a very short trip to the EP lab. As soon as I was wheeled into the lab there was a team of people waiting for me, and they went to work on me immediately. A couple nurses were putting pads on my back and chest while others were asking me questions and doing whatever prep work they had to do.

Within ten minutes of being wheeled into the EP lab they had me ready to go and were putting me to sleep. The last thing I remember as I was drifting off to sleep was one of the nurses telling me, “you’re in the very best of hands, Mr. Van Slooten. Relax and don’t worry about a thing.”

Immediately After the Ablation

I don’t remember much immediately after the ablation. I remember being wheeled into my recovery room and seeing my wife and daughter in there waiting for me but that’s about it. While I was awake and fairly alert, I was still groggy and “coming to.”

As I started becoming more alert, I turned to my daughter and asked her to take a picture of the heart monitor and the puncture wound in my neck. I wanted to be sure I had those photos for my blog. That’s right, the first thing I thought of immediately after my ablation was my loyal blog readers…lol. But in all seriousness, I wanted to make sure I had photos to share with you!

My heart was in normal sinus rhythm and beating a healthy 72 beats per minute.

Here is the picture of my neck puncture wound where one of the catheters was inserted during the procedure:

Here is what the puncture wound looked like the day after my ablation with the bandage removed:

I don’t remember the exact time I was wheeled into my recovery room, but I think it was around 1:15 pm. As I was lying there talking to my wife and daughter, the nurse told me I had just a little over an hour to go before I could get up and move around, which would have been 2:15 pm.

VASCADE Vascular Closure System (aka collagen plugs)

When you have an ablation, they have to insert catheters into your left and right groin. Those holes have to be covered so they don’t bleed and so they can heal. Before collagen plugs, they used firm pressure and bandages and had you lie still on your back for six hours.

Now, collagen plugs are inserted into the holes after your procedure and then covered with bandages. These collagen plugs allow you to get and up move around just a couple hours after your ablation. You no longer have to lie still on your back for six hours and you no longer need a urinary catheter (a huge bonus for us guys…lol)! The plugs dissolve after a few weeks.

The brand name for the collagen plugs that were used is VASCADE Vascular Closure System. Here is a picture taken of my collagen plugs and bandages:

Here is a picture taken the day after my ablation after I was released from the hospital and had a chance to take a shower and remove the bandages:

No More Urge to Pee After the Ablation

When the clock struck 2:15 pm the nurse came into my room and asked me enthusiastically, “O.K. Travis, are you ready to get up and move around? I imagine you have to go to the bathroom by now.”

I told her I wasn’t ready to get up just yet and had zero urge to go to the bathroom. She said that was perfectly fine. She said some people are itching to get up as soon as they can while others like to wait a while. It was totally up to the patient.

The irony is the morning leading up to the ablation I had the constant urge to pee. In fact, I was going to the bathroom every 90 minutes like clockwork. Post ablation, I had ZERO urge to pee. Before the nurse left the room, she asked me a couple of times if I was sure I didn’t need to get up to at least go to the bathroom. I told her no; I was perfectly fine.

When you have an ablation, they are pumping you with fluids throughout the procedure to the point you will gain significant water weight, enough to warrant the need to take Lasix (or generic name furosemide) to get rid of that extra fluid. It’s not uncommon for a patient to have the strong urge to pee a couple hours after the ablation to get rid of all that access fluid. But it’s also not uncommon for some not to have the urge to pee because sometimes that anesthesia dulls the urge to pee.

My Aches and Pains After My Ablation

After the nurse left the room, my wife helped me place an order for lunch. I ordered chicken noodle soup with a chicken sandwich. Around 3:15 pm my lunch arrived, and my nurse stepped in to see if I was ready to move around yet. I told her not yet but probably after lunch.

After I ate, I told my wife and daughter that they could leave if they wanted. They had been sitting around the hospital all day and there wasn’t anything they could do for me anyway. I was doing well overall and there was no need for them to babysit me or sit around the room being bored. I told them I’d call them later that night and I’d see them again in the morning.

Just like my first ablation, I had zero pain, but unlike my first go around, there were three surprising differences. After my first ablation, I had some pretty intense chest discomfort the first 24 hours. This time, I had very little chest discomfort. The only time I had any chest discomfort was when I would lie down on my back. It felt like someone was slightly pushing on my chest. It wasn’t pain at all, just noticeable chest pressure. Then it would go away within a few minutes and I was perfectly fine.

That chest pressure is totally normal after an ablation. If you think about it, your heart has just been burned up and is highly inflamed. The more involved your ablation (i.e. the more burning of the heart), the more chest discomfort you’re going to have. Since this was mostly a touch up ablation, I didn’t have as much burning so the inflammation was likely much less this time around.

The other difference between my first ablation and my second ablation was my throat discomfort. When you have an ablation, they put a breathing tube down your throat during the procedure. When the breathing tube is removed it is totally normal to have a temporary sore and dry throat. My throat was noticeably sorer and drier this time around.

It hurt to swallow, and it felt like I had a large sand block stuck in my throat. I was given Carafate (sucralfate) to coat my throat and an unlimited supply of popsicles and ice chips that I took full advantage of! My throat remained sore and dry as sand until the evening after my ablation. By Friday night, though, my throat was almost 100% normal. By Saturday morning all my throat issues were gone.

The third surprising difference between my first ablation and my second ablation was the soreness of the puncture in my right neck. After my first ablation, I had zero pain or aches in my neck. This time around, my neck was very sore and remained sore for a few days after my ablation. The area around the puncture wound also formed a slight, yellowish bruise about five days after my ablation that went away after a day. I didn’t have any bruising on my neck after my first ablation. The soreness wasn’t anything debilitating or concerning at all. It just felt like I had a constant stiff right neck for a few days.

Water Weight Gain After the Ablation

Around 4:50 pm I was finally ready to get up and go to the bathroom so I buzzed the nurse. She came in and watched me get up and was ready to support me if necessary. I felt totally fine, however, and didn’t need any assistance. I went to the bathroom and then afterwards the nurse needed to take my weight.

When I checked into the hospital that morning before the ablation I weighed just shy of 210 pounds. When I stepped on the scale, I weighed just over 213 pounds. I had gained almost three pounds of water weight! Again, this is totally normal after an ablation given the amount of fluids they pump you with during the procedure.

To make sure you’re losing all that fluid and not retaining it, whenever you pee, they have you pee in a jug that measures how much you went. The nurse then records it. This way they can track how often and how much fluid you’re getting rid of during your hospital stay. The nurse never told me what metrics are good or bad but every time I went, I peed between 350-400 ml of urine, which the nurse said was “very good.”

After she took my weight, she wanted me to move around a little so she had me take a walk with her down the hall. I felt totally normal walking and it was great to be up and moving! When we were done, she encouraged me to walk around the halls as much as I wanted.

When we got back to the room, I stayed on my feet for a good 20 minutes or so as my back was getting achy from lying around so much. It felt good to be on my feet. I then sat down in the reclining chair they had in the room and watched TV for a while.

I’m Told My LAA was Ablated

At some point as I was sitting there watching TV, Dr. Natale came in to check on me and to let me know what he had done during the ablation. After shaking my hands and asking me how I was doing he said, “I had to ablate the LAA.” I could tell it pained him to tell me that as he was hoping to avoid having to do that.

He said all other areas of my heart were quiet as a church mouse from the first index ablation he did almost eight years ago. That was great news to hear! He said the primary activity was coming from my LAA (left atrial appendage) and there was also a little activity coming from the coronary sinus. He ablated the LAA and did a touch up on the coronary sinus as he had ablated the coronary sinus during the first index ablation back in 2015.

Because the LAA was ablated, he said I would need to come back in three months and have the Watchman device implanted in the LAA. I thanked him for the update and said I looked forward to seeing him in the morning as he said he would be stopping by one last time in the morning.

I was honestly relieved to get the news. I knew this day was coming sooner or later and I had been praying for quite some time that if my a-fib came back, I wanted the LAA to be the source of the a-fib so I could get this atrial fibrillation treated for good once and for all. What do I mean by that?

LAA as a Common Source of A-Fib

I’ll be writing another blog post about the LAA and the Watchman Implant, but for now I’ll just say that there are many potential sources of a-fib activity in the heart. The most common source is the pulmonary veins. The pulmonary veins are also the easiest source to ablate. Most EPs do pulmonary vein ablations only because of this.

The problem with only ablating the pulmonary veins is that most of us that have a-fib, the a-fib activity comes from other sources in the heart that also need to be ablated if you want to put a-fib to bed. Only highly skilled and experienced EPs like Dr. Natale can safely and effectively ablate all potential sources of atrial fibrillation. When EPs like Dr. Natale do an index ablation, it is far more extensive and “complete” than a typical PVI ablation most local EPs do.

The result of a more thorough ablation is that a significant portion of patients can go years after just one ablation without any a-fib activity before any touch up ablations are needed. I went almost eight years after my index ablation, for example, without any a-fib!

There are two stubborn areas of the heart, however, that often drive a-fib activity. Those areas are the left atrial appendage (LAA) and to a lesser extent, the coronary sinus. These areas are not easy to ablate because it requires a very skillful operator to do, which is why most EPs won’t touch them. Just ask your local EP if he does LAA ablations. You’ll probably get no for an answer.

Not only is the LAA challenging to ablate, but once you do, you dramatically increase the risk of blood pooling in the appendage, which in turn dramatically increases the risk of stroke. To decrease this risk, you have two options: be on a blood thinner for life or have the Watchman device implanted into the left atrial appendage, effectively sealing it up so no blood can enter the appendage.

The reason I’m happy my LAA was ablated is because in theory, the most challenging source of a-fib has effectively been killed. I say “in theory” because most LAA ablations require a touch up or two given the difficulty of ablating the LAA. It is a very tough, rubbery-like tissue that often requires a couple ablations for long-term success. Once the LAA is fully ablated for good, you eliminate a common and challenging source of a-fib activity! Also, if all goes well after having the Watchman device implanted and after it is fully sealed over, I will no longer need to be on a blood thinner!

Bottom line, after my extensive index ablation and now my LAA ablation, and upcoming Watchman implant, I have a very good chance of being done with a-fib for a very long time. Granted, I may very well need a touch up ablation or two down the road to fully button up the LAA, but for the most part my battle with a-fib could be coming to an end for a very long time. Even if I only go 10 or 15 years before a-fib returns, I’ll consider that a huge victory!

My Atrial Ablation Report

As I did for my first ablation, I requested a copy of my ablation report. The ablation report is a detailed technical report that describes precisely what was done during the ablation. After your ablation, always request a copy of this report while you are still in the hospital. Just tell them you want a copy of the ablation report included with your discharge papers.

You may need to remind them a couple of times to do it, but it’s important you leave the hospital with this report physically in your hands if you can. Some hospitals may not be able to get you a physical copy before you leave so they’ll email it to you or mail it to you. Regardless, just be sure to get a copy of it for your own records.

You can see my a-fib ablation report here as well as an interpretation of it, compliments of Steve Ryan of a-fib.com.

Most patients never see this report as it is mainly an internal recording document for the hospital so it’s not written with the average patient in mind. There is a lot of medical mumbo jumbo, but it’s a goldmine of information if you can have someone interpret it for you.

It’s a shame that hospitals don’t create a user-friendly version of the ablation report and provide that to patients along with their discharge papers. They could easily “dumb down” this report to make it easy to understand what exactly was done. Sadly, most patients that have had an ablation have no clue what exactly was ablated during their procedure because they never see this report and if they do they have no idea how to interpret it.

My Bladder Ultrasound & Overnight Hospital Stay

The rest of the evening and overnight stay in the hospital was uneventful. The nurses came into my room about every four hours to check my vitals and my groin to ensure my collagen plugs were holding up.

Right before the nurse came in at 11:00 pm to check my vitals and groin, I went to the bathroom. I asked her if it was a problem that I haven’t had the urge to go to the bathroom hardly at all since my ablation. Furthermore, whenever I peed, I felt like I wasn’t going that much, or that my bladder wasn’t completely emptying.

She walked into the bathroom to look at my urinal jug and she said I had just peed 400 mL and my last one at 8:00 pm was 350 mL. Those were perfect amounts she said. In my boredom later that night I researched this topic, and I learned that the normal amount of urine when you go to the bathroom is between 250-400 mL so that explained why the nurse said my urine output was “perfect.”

Out of an abundance of caution, however, she said she wanted to do a quick bladder ultrasound to make sure I wasn’t retaining too much urine. She said it’s not uncommon to retain some urine for a period after an ablation. As she put it, sometimes it just takes a little time for the bladder to “wake up” after the procedure.

The bladder ultrasound was quick, easy, and painless. She just placed some gel on the lower portion of my stomach and gently moved an ultrasound wand around to take a quick look. She said I had 150 mL of urine in my bladder, which was good enough to avoid needing an “in and out” urinary catheter, also known as an IC. If you have 300 mL or more of urine in your bladder after peeing, then you need that type of urinary catheter to empty the bladder. I dodged a bullet on that one!

As someone that has had insomnia for years, I’m lucky if I can piece together 5-6 hours of sleep on a given night. When I’m in a hospital, forget about it. I’m not sleeping at all. I shared this with the nurse and she jokingly told me that she doesn’t think you’re supposed to sleep in the hospital because she said patients rarely get a good night of sleep in the hospital.

Since I only slept two hours the night before, I really wanted a shot of being able to sleep so I asked the nurse if I could get 5 mg of Ambien. She was happy to accommodate my request. Unfortunately, it didn’t do much. I still only slept two hours. I didn’t fall asleep until after my last vitals and groin were checked at 4:00 am and I was up already at 6:00 am.

My Morning Lasix and Potassium

I got up and went to the bathroom and ordered breakfast. The nurse came in and gave me two large potassium tablets and then gave me Lasix through my IV line. This is standard protocol for all patients. Lasix is a strong diuretic that is used to reduce extra fluid in the body.

The nurse warned me that I would be going to the bathroom several times once the Lasix kicked in. When all that fluid is lost through urination you also lose a lot of potassium. That is why you are given potassium tablets right before the Lasix to replenish the potassium in your body.

Potassium plays a critical role in keeping your heart rate steady. You are at a high risk of heart arrythmia if you are low in potassium. A sudden drop in potassium levels is a sure way to get your heart rocking so if you’re peeing a lot for whatever reason, or sweating a lot, make sure you replenish your potassium!

The Lasix definitely made me go to the bathroom but not like I thought it would. I probably went to the bathroom about every thirty minutes for about two hours but that was the extent of it. I was expecting I’d be going every fifteen minutes or something crazy, but that wasn’t the case at all.

Final Meeting with Dr. Natale and His Team

After breakfast, Dr. Natale came in with two of his nurse practitioners. It was sort of like a team huddle as they stood around me asking me how I was doing and answering any questions I had. They also gave me the run-down of what was to transpire after they discharged me.

They said now that my LAA was ablated, I had to be especially diligent with my Eliquis until I get the Watchman device implanted. It was imperative I never miss a dose! This warning was repeated multiple times.

I was also told not to lift anything over ten pounds, and to refrain from any exercise or excessive activities for the first week. After that week, however, I was told to resume all activities including whatever exercises I normally engaged in. Nothing was off limits.

I don’t know if this was the case or not, but I got the sense they were encouraging me to be active. I found it odd because to me it didn’t make sense. They call the three-month recovery period after your ablation the “blanking period.” During this time, the heart is still inflamed and healing. Unless I missed the memo, this three-month blanking period still exists today. I don’t think anything has changed.

Why then would they encourage “pushing” your heart after just one week out from your ablation? After my first ablation, I took an extremely conservative approach to exercise and activity during my first blanking period. I refrained from any exercise for the first six weeks. Then when I started to exercise in month two, I took it very slowly. I started with slow short walks and over the course of the month I worked myself up to longer more brisk walks. It was well into my third month of the blanking period before I was 100% back to my normal exercise levels.

I admit I was probably being way too overcautious back then, but a more conservative approach just makes more sense to me than pushing your heart one week after it has gone through an ablation. I’m not sure what I’m missing.

I don’t know how I’ll handle my blanking period this time around. I’m not very active these days to begin with…lol. I walk two miles every day at about 65-70% of my maximum heart rate, which is about 100 bpm. It’s basically a very brisk walk. On a treadmill, it’s walking at 4 mph with a 1% incline. It’s not intense at all.

I will probably wait a couple weeks after my ablation to start walking again and when I do, it will probably only be for a mile, and it probably won’t be over 3 mph. We’ll see how it unfolds. I’ll be documenting my entire 3-month blanking period on this blog so be on the lookout for it.

The other thing they told me was that I had to email them an EKG every week “for the next several weeks” using my Apple Watch or Kardia heart monitor. This was a big change from when I had my first ablation. After my first ablation, they sent me home with a clunky heart monitor that also required a landline phone.

Now you just email them an EKG using your Apple Watch or Kardia heart monitor. Technology has come a long way in eight short years!

I wonder what they do if you don’t have an Apple Watch or Kardia heart monitor? They didn’t say and I didn’t ask. I don’t know if they would require you to go out and buy one or if they would send you home with a heart monitor. My guess is they would supply you with a heart monitor, but I don’t know for sure.

The other thing that was different this time around was I didn’t have to take Lasix pills or potassium tablets after I was discharged. After my first ablation, they gave me a Lasix prescription and potassium tablets that I had to take for a couple days after I was discharged.

They gave me the same prescriptions this time around, but now I wasn’t required to take them. I was told to take them only if needed. They said if I noticed fluid retention such as swelling in my stomach or ankles I had to call them. They would then determine at that point if I needed to take the medications.

Because my ablation this time around was shorter than my first one, they probably didn’t have to use as much fluid. And because there was likely less inflammation this time around, there was less risk of fluid retention. I don’t know for sure, but either way I didn’t have to take the medications because I never experienced fluid retention.

I was to continue the colchicine and tamsulosin hcl (Flomax) I was prescribed a week before the ablation until they were gone. I finished those five days after my ablation. The only medication I’m on now is Eliquis.

Finally, we discussed “next steps.” Specifically, getting the Watchman device implanted. I told them I had a logistics issue to work around. We get our health insurance through my wife’s employment. We have had the same insurance company and insurance plan for years, and overall, it has been pretty good. We’ve had zero issues with them or the plan we’ve had.

As luck would have it, my wife’s company announced at the beginning of this year they were changing insurance companies starting April 1st. They assured us it was going to be much better, but I have a hard time believing that. I have a bad feeling that the coverage is going to be worse, and it’s going to cost more! Even more worrisome, I am concerned that St. David’s won’t be in-network as it is with our current insurance company.

This could be a potential nightmare to navigate because Dr. Natale wants to have the Watchman implanted in April sometime. I’m praying that St. David’s is in the new insurance company’s network and that they’ll o.k. the procedure.

I explained all of this to Dr. Natale and his team and they said they would try their best to get it scheduled by the end of March so it could be covered by our current insurance company and healthcare plan, but they couldn’t promise anything. If they can, that will be one less thing I have to worry about.

If I can’t get in until April, then we’ll deal with whatever cards we’re dealt with at that point. Hopefully there won’t be any issues with the new insurance company. I guess we’ll have to wait and see how everything unfolds.

Dr. Natale and his team left, wishing me well and telling me they look forward to seeing me in a few months.

About an hour later my nurse came in to go over my discharge papers and to officially discharge me! I was walking out of the hospital with my discharge papers in hand on Friday, January 20th at around 10:30 am.

Now on to the three-month blanking period!

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