My 3rd CTA Chest Scan Results and Next Steps

It’s been a while since I last updated this blog. I’m not very active on this blog anymore. Google makes it impossible for health blogs to be found these days unless you’re a high authority medical figure or are tied to a high authoritative medical organization, hospital, etc.

Try testing it yourself. Do a Google search for any number of atrial fibrillation related keywords and the only search results you’ll see are for places like Mayo Clinic, National Heart Association, National Institutes of Health, Cleveland Clinic, Johns Hopkins, and the list goes on. You will not find a blog, let alone an a-fib patient’s blog, of any kind. The days of diverse search results on Google are long gone.

Prior to Google’s change to their algorithm, the traffic to this blog averaged about 30,000 visitors per month. Those were the glory days for sure. For the past few years, this blog has only averaged around 1,500 visitors per month. I’ve simply lost the motivation to maintain this blog given that hardly anyone sees it anymore. It’s a ghost town around here.

I also don’t have any interest in hustling to get this blog found. Sure, I could post YouTube videos, be active on social media, reach out to influencers, etc. but honestly, I don’t have enough interest in sharing my atrial fibrillation story that way. I don’t want to make my medical condition my full-time vocation. To be completely frank, after 3 ablations and multiple cardioversions over the years, I’m growing tired of thinking about or writing about atrial fibrillation.

I’ve also come to the realization that here really isn’t anything new I can share about atrial fibrillation. All I can offer is the same advice I’ve been giving since day one: if you have atrial fibrillation the best treatment option today is an ablation. And if you’re going to have an ablation, it’s imperative you find an experienced EP to do it. See this blog post about that topic and this forum post on Afibbers.org.

Other than that advice, there isn’t anything I can share with others that will help because I’m not a doctor and I’m not an expert on anything health related. All I can do is share what I’m going through, and if I’m not going through anything, there isn’t anything to write about! Fortunately, there hasn’t been much I’ve been going through so it’s been quiet on this blog.

Picking Up Where I Left Off

My last blog update was on December 3, 2023, almost a full year ago. Wow, time flies. In the blog post I detailed my CTA chest scan experience and what the end result was. Unfortunately, I was told my Watchman wasn’t fully sealed. They detected a tiny leak. It was so small that I as given the green light to stop blood thinners if I wanted to. That’s how insignificant the leak was. They were also confident it would eventually fully seal.

I didn’t stop the blood thinners because around that same time I got COVID. Apparently, potential blood clotting is a thing when you have COVID so taking a blood thinner can be a smart thing to do.

After about two weeks I was fully recovered from COVID and was just about to stop the blood thinners when I got a call from my doctor that he wanted to have a virtual appointment with me. The appointment took place within a week or so of that call.

Long story short, my doctor apparently had a change of heart (no pun intended) and he wasn’t comfortable with me stopping the blood thinners. While he couldn’t see the leak that Boston Scientific saw, he said the prudent thing to do would be to stay on the low dose blood thinners until my next CTA chest scan, which would be in May 2024. To say I was bummed is an understatement.

Side Note: When you have the Watchman implant put in, for the first year you have periodic TEE’s or CTA chest scans to monitor the healing of the Watchman implant. The results of those TEE’s or chest scans are sent to Boston Scientific, the makers of the Watchman implant. They apparently have a team of doctors/experts that review them, and they determine if there are leaks, how bad they are, etc. They are also the ones that confirm when the device is fully sealed over. Your personal doctor looks over the results as well and makes his own judgments, but they will ultimately default to Boston Scientific as to what to do.

CTA Chest Scan #2 – May 14, 2024

I had my second CTA chest scan on May 14, 2024. I went to the same local hospital I went to for my previous chest scan in October 2023. The experience of the chest scan itself was exactly the same as the one before. You can read about it here.

Unfortunately, the results of the chest scan were exactly the same as the one before. I still had a tiny leak. Can you believe that? Just my luck. Most Watchman implants are fully sealed after a full year, but not mine. I was so angry.

There was some good news, however. The leak was improving some and so I was given the green light to cut my blood thinner dosage in half. Instead of taking 2.5 mg of Eliquis twice a day, I was able to go down to 2.5 mg of Eliquis once a day. Since most strokes occur in early morning (according to this study), I decided I would take my daily dose around midnight shortly before I went to bed.

CTA Chest Scan #3 – September 17, 2024

I had my third CTA chest scan on September 17, 2024. I had my third CTA chest scan at the same hospital as the previous scans. And once again, the actual scan experience was the same. And sadly, once again the results were the same too.

I wasn’t told I still had a leak until November 25, 2024. It took over two months after this third scan before my doctor’s nurse had time available to go over the results with me. I had to sit and wonder for over 60 days what the news was going to be. I wasn’t exactly thrilled about this delay but what was I going to do about it?

When I finally had my appointment with her, she said they (Boston Scientific) are still seeing a leak, but it is improving. I was thinking to myself, how big is this stupid leak that according to every scan it’s getting better but is still not sealing? And why was I initially told after the first chest scan that the leak was apparently so tiny that I was given the green light to stop taking blood thinners? Either the leak was bigger than I was told after that first scan, or the leak has always been the same “tiny leak” and hasn’t really improved at all.

At any rate, she told me that I needed to stay on the once daily 2.5 mg of Eliquis for another year and then we’d have yet another CTA chest scan in November 2025. I couldn’t believe what I was being told. I opted to have a Watchman implant so I could stop blood thinners, but now I couldn’t stop taking them because of the Watchman! It was all too ironic.

Time Out – What Does My Local EP Have to Say About This?

As luck would have it, my annual checkup with my local EP just happened to be scheduled on September 18, 2024, the day after my third CTA chest scan was completed. I LOVE my local EP. He’s the best doctor I’ve ever had. I wish he had the ablation skills and experience that Dr. Natale has because I would love for him to be my only doctor. Fortunately, my local EP is totally cool with me having my ablations done by another doctor and then providing whatever support and help I need outside the ablations.

He reviewed the chest scan results since the scan had just been completed the day before and he said as far as he could tell, the Watchman was definitely sealed, but Boston Scientific obviously hadn’t reviewed the results yet. He said if it was his call, he’d tell me to stop taking the blood thinners. He also questioned the efficacy of taking one 2.5 mg dose of Eliquis. As he said, how much additional protection are you really getting with such a low dose? Probably not much. He said EPs are making judgment calls all the time with this stuff. It’s not an exact science.

I was so happy after that meeting with my local EP. I was practically skipping leaving his office. Finally, after over 1 1/2 years I was seeing light at the end of the tunnel. I was finally going to be able to come off the blood thinners. I decided to hold off, however, until I heard from Dr. Natale’s team in November. I figured if my local EP told me my Watchman was fully sealed and I could stop taking blood thinners, certainly Dr. Natale would tell me the same thing in November. I figured I could hang in there and stay on the blood thinners for two more months just to be safe. Unfortunately, as you read earlier in this blog post, my appointment with Dr. Natale’s nurse didn’t go as planned.

Next Steps

I’ve had so many mixed messages throughout this Watchman healing process that I don’t know what to think anymore. Just how bad is this leak anyway? And is it really getting better, or am I being fed a bunch of BS just to give me hope that someday I might be able to stop taking blood thinners? Who knows.

To be honest, if I have to take just one 2.5 mg dose a day of Eliquis the rest of my life that isn’t the end of the world. Yes, it’s super annoying and frustrating, but it’s still better than having to take a full 5 mg of Eliquis twice a day. Don’t get me wrong, I’d LOVE to be able to come off blood thinners completely but at this point I’m not very hopeful.

There was a time in my life that this would really anger me and drive me to find answers, but at this point in my life, I just don’t care. As long as I don’t have atrial fibrillation or atrial flutter, and as long as I’m not having bleeding issues or any side effects from the low dose Eliquis I’m taking and I’m not stroking out, I’m fine.

I don’t regret having a Watchman implant. Had I not done it, I’d be on a full dose of Eliquis for the rest of my life. That would have been a nightmare as I’m prone to nose bleeds and I’m prone to cutting myself when I’m in the kitchen..lol. I also wouldn’t want the constant reminder that I could potentially bleed to death if I had a bad accident of some kind if I was on a full dose of Eliquis.

For those reasons alone, I will be eternally grateful for the Watchman implant I have even if I still have to take a small dose of Eliquis. But I would be lying if I didn’t admit I was bummed I was one of the unfortunate ones that got one that didn’t fully seal so I could stop the blood thinners entirely.

I guess all there is to do now is stay the course. I’ll continue taking my one 2.5 mg of Eliquis every night and will have a CTA chest scan in November 2025. At this point I have no hope that I’ll ever be given the green light to stop blood thinners. I’ve resigned myself to taking some dose of Eliquis for as long as I live. I just hope I don’t develop any side effects from it in the years to come. I also hope I remain in normal sinus rhythm!

Share this article with others