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Valentine's Day: The Heart...It's Complicated!

Friday, February 14, 2014

Here I was ready to march off and either zap ye olde heart or slap a pacemaker in and be good to go!

Sadly no such simple solutions await...

My EKG confirmed a return of the atrial flutter, however with some worsening features that make a solution tricky and outside the range of my current cardiologist's area of expertise. She is more of a "plumbing" sorta gal. Me? I need an electrician. My right atrium is not filling completely, nor is it emptying completely. The other three quadrants of the heart attempt to compensate for this which counter-intuitively (to me, at least) causes my heart rate to slow down.

So I'm being passed along to a cardiologist who is an "electrical physiologist".

The way I understand it is he will "map" my heart's electrical impulses to determine what intervention he feels will be most helpful. It may involve a "re-mapping" with possible pacemaker as part of the solution, but not likely the total solution.

There may be ablasions in my future where some of the nerves are cauterized for the re-mapping efforts. Pacemaker may or may not be needed. My condition sounds like it will wax & wane and require ongoing tweaking and monitoring...even if a pacemaker is used, which may or may not happen.

I need to take a blood thinner, but am going to try the new drug Eliquis which doesn't require the blood work and tweaking that Coumadin requires. But like Coumadin it will make me at risk for bleeding and bruising and UNLIKE Coumadin there is no counter-acting agent so if I start bleeding I won't stop. Need to be way WAY cautious about this...! This is necessary to avoid throwing clots and also to allow the doc to follow through with whatever procedure he feels needs to be done, ablasion, whathaveyou.

So: no road cycling until I'm off the blood thinner. Just not going to risk it. Even nervous in thinking about cx skiing...all the "what-ifs"? Such as what if I fall, twist an ankle, bruise a knee, etc...?

It's still pretty confusing to me and I really don't have a clear conceptualization of the cardiac electrical system and more precisely how mine is so wonky. I am having a really tough time feeling like I have even a basic understanding or grasp of what the heck is happening...which is frustrating as all get-out!

Here is a link which I believe SHOULD explain things for me, however I have a hard time "grokking" it:


The good thing is that of all the ways the cardiac electrical system can go wrong, mine is pretty innocuous. I have no limitations on my physical activity other than to be prepared to feel more fatigued than I oughta feel when I pump it up. The worst case scenario is that my fatigue may lead me to pass out but without any ill effect.

But even without any limitations by my cardiologist I'm having a mixed sorta reaction of being blase (hey I'm tracking my food, don't have to worry about weight gain) but also fearful...with my heart hobbling along do I really wanna pump it up to an HR of 120 or above?

The weight loss has leveled off despite holding the calories down around 1400-1600...so this may nudge me into action. Workouts have been my "North Star"...don't want to lose this mojo, even if I AM building a NEW North Star: Food tracking.

I'll be seeing the new cardiologist, my electrician on 2/24 so stay tuned...

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Member Comments About This Blog Post
  • _MOBII_
    It is a lot to take in and learn, but it sounds like you are getting excellent care. I always prefer (read:expect) doctors who take the time to explain things so we can understand them and who make sure that we understand what is happening with our body.
    I am so glad that you are getting some answers.

    Take care
    2533 days ago
  • no profile photo CD14245438
    Don, I'm so sorry to hear of this development, but it sounds like not only are you in good, capable hands - and can avail yourself of some solid clinical judgment - but that you, too, have a sound grasp of the situation's various ramifications. I have a feeling you'll be in the care of an excellent cardiac "electrician" and that the problem will be handled with reassuring success. My brother had both a cardiac ablation and pacemaker implant close to 20 years ago. Keep us posted on your progress; I have a good, positive feeling about you and the outcome of this situation! - Susan
    2536 days ago
    Oh, my. Not the heart focus you wanted for Valentine's Day, absolutely. And: quite an overwhelming whack of info to assimilate and then accommodate. I'm guessing that gym workouts (elliptical, ST etc.) should be fine but totally agree: bike/XC ski sound like too much potential risk for injury/bleeding at the moment. You are at least getting very thorough medical assessment and the assurance an appropriate program will be mapped out for you.

    Will be thinking of you and hoping for all best, Don.
    2537 days ago
    This does sound complicated..I am hoping your new doctor can explain it and offer new ways of helping you. I would stay off of your beloved cycling and skiing while you are on that blood thinner. I know your love of exercise will help you to find a way to continue it. This is a hard frustrating time for you. I am keeping you in my prayers. Hugs.

    2537 days ago
  • _LINDA
    Some scary stuff alright:(( The Dr. does say its okay to exercise though, and why not? Before you knew what was even going on, you were giving 'er to no ill effects or damage.. But while on the blood thinner, yes, you do not wanna get road rash.. You need to find something safe that you like to do. Tracking food is great, but I can tell you sitting around doing nothing gets old fast. In the olden days, after recoveries or flares, I would be doing video games 24/7, but if there was anything at all I could exercise at, I would find a way..
    Hoping this Dr. can find a solution that won't leave you hanging in the air..
    2538 days ago
    My Mom has had ablations.
    2538 days ago
    Gah -- things are never as simple as we want them to be! Praying that your new cardiologist has some good answers for you that will get you on the right track.
    2538 days ago
    It does sound complicated. Hopefully after you see the EP doc you will get more clarity on your condition. In the mean time find some things you can do to keep moving w/o getting the HR pumped up. I will be praying for you and will be staying tuned. Wishing you the best.
    2538 days ago
    Sorry for the detours on that path, Don! Hope you will continue to keep us in the loop... it's a bummer because I know how much you enjoy the cycling and skiing. There has to be a safe level of activity? Doesn't there?

    Spark gently, friend!
    2538 days ago
    OMG! Some kinda' Valentine's surprise THIS is!!! Wonder what the etiology of this is? I'm confident you are receiving skillful medical care and you will carry on with the superb stewardship you are offering that currently naughty body which is in your care!
    2538 days ago
    Don, as Valentine's Day heart messages go: this one sorta stinks, my friend! BUT!! Thank heavens you KNOW of this problem now! Yup, you are entering yet another phase of your journey. Ah, life: challenges always do emerge, don't they?! Yeah, the blood thinner has drawbacks, but... it can save lives. My dad bleeds easily from his but blood loss has not been extreme, even though at almost 92 he is also thin skinned. As he says, "it's the way it is and I'm still here while most of my friends are not". Amazing what we can accept when faced with change. Good thing you enjoy and know good melodies; nothing like music to help keep the stress level down while coping with change!

    With all the new medical understanding and technologies this unfair new development will complicate life, but your electrician can work miracles. Thank goodness you have lost that weight; had this happened several years ago, you would not have been in as good a fighting stance.

    You're in my thoughts; am cheering for speedy solutions.
    Keep us up-to-date, k?
    (Good grief; you didn't shovel snow today, didya???)
    2538 days ago
    It actually sounds like you have a very good grasp of the difference in plumbing and wiring when it comes to the heart. Your next provider will probably provide you more clarity on the later. Keeping you in thoughts and prayers!
    2538 days ago

    I went to an electrophysiologist myself down in PA @ Guthrie!

    My issue was not the same as you though.. other that a few missed beats and tachycardia!

    I had my work done up in Syracuse @ St Joseph's . . great team up there!

    Sorry to hear you are off the wheels.. but you cannot risk a tumble and scratches way out where you ride . . I agree . . too risky Boss!

    That being said . . please don't let fear cripple you as it did me! Ask . . Ask . . Ask what you can still do and what is a safe heart rhythm rate!

    I wish you all the best!! I am also here if you need someone to chat with!
    2538 days ago
  • no profile photo CD14253479
    Wow, mixed bag of news for sure. I'm one who goes alternate methods of healing, even the heart can heal and I don't mean that in the romantic sense.

    It sounds like your insurance company is going to get a hefty bill.

    The most important thing is that hopefully you will indeed continue on your path to living life to it's fullest.

    Happy Valentine's day.
    2538 days ago
  • L*I*T*A*
    sounds like you will get the answers you seek soon.......
    good luck with the new cardiologist....
    hoping and praying for your best outcome.....
    blessings and hugs....lita

    emoticon emoticon emoticon
    2538 days ago
    All the best of luck to you with your heart health!
    2538 days ago
    Yikes! Blood thinner without an antidote sounds like a bad game of Russian roulette with no empty chambers. :( :( :(
    2538 days ago
    Interesting info and sounds like your next doc will be able to get more specific in treatment plan. Take care and wishing you the best outcome.
    2538 days ago
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