A Fib

Well, last Tuesday I went to the Drs. for my annual physical. First the eye exam where they dilated my pupils. I arrived at my primary care provider's (reg. doctor) office looking like I'd just done some mescaline (or at least what I suspect someone who'd just done mescaline would look like.). So, I get the usual height (Hmmm, I'm shrinking), weight (hmmm, earth's gravitation pull has increased somehow...) and finally an EKG. The tech had to run the tests three times. I'm thinking, hah, nube. She ushers me into the exam room and the PA comes in and says, "Sir, your pulse is 127 and you appear to be in A Fib." A what? She explains what Atrial Fibrillation is and how potentially dangerous it is (clots, congestive heart failure, etc.). "You should get to an E/R right away, would you like us to call an ambulance?" Whoa, whoa, whoa! I feel fine, I mean, maybe I had a little too much coffee this morning, but I'm okay. No you're not, look at the EKG. Fortunately a hospital with an excellent cardiac department (Mather Hosp. Port Jeff, NY) is across the street and she reluctantly allows me to drive.
I get to the E/R and I get to go to the head of the line, no waiting. Oops, that's not good. I never get seen in an E/R in less than two hours. The E/R nurse says we've got to put you on some anti-coagulants and blood thinner. We're going to have to admit you sir. But I feel fine... Another nurse comes by and asks questions; cardiac history? No. Family cardiac problems? No. Previous incidents, heart palpitations, shortness of breath? No, well maybe occasionally. Do you drink? Yeah occasionally. How occasionally? 1-2 brews a night. Every night? Yeah. Then, there's that look. I know you're bs' ing me. I think to myself, hmm, I have been really enjoying my hombrews a lot lately. Every doc or nurse that saw me for the first time and there were a lot of them, asked basically the same questions and gave me the same look about the drinking.
I spent two and a half days in the hospital with all sorts of tubes (Heparin and Cardizem) stuck in me and pads for the EKG. Xrays, echo cardiogram (pretty cool to see my own heart) and lots of blood work. With the echo I could see that my valves were misfiring, or staying open too long. My cholesterol and LDL levels were a little high but not enough to have caused this. Echo said I had a good heart. The EKG showed my heart rate running from 80 to 113 in a few seconds. The cardiologist said if the drugs don't work we'll have to do "cardioversion." What's that? It's where we shock your heart back into regular rhythm. Like in the movies, except a little less dramatic.
Thinking about losing my life and family made me put things in perspective. Mr. Beer and I (not the little brewing system) were gonna have to start seeing less of each other. I'm putting this out there as sort of a PSA. I still had some of the 20-something bullet proof attitude and am starting to realize I'm not. Oh, I also have the Navy to thank for this. If they didn't get me on this yearly physical thing, I might not have found this. (steps off soap box)

When I saw the title, I thought, "Afib--don't post about it, go to the hospital!". Then I figured someone was telling a little lie, but you really were talking about your heart. Glad to hear that you caught it. I think the medical professionals hear so many lies about alcohol consumption that they automatically assume double the admitted quantity.

Yes, I too just went through the whole ecocardiogram, stress test game with the doctors. Luckily for me everything came out fine. But, the doctors are skeptical when you tell them 1-2 beers a night. Which for me is the truth. But like Sharoa stated. They are used to doubling whatever anybody says about their vices. Most people lie to the doctors. I've always wondered what drug addicts say to the anesthesiologist. Do they lie knowing it may kill them and they may never wake up? The ones I have asked say they do lie. I don't get it. Well....I guess I do. Tis a shame.

I'd be very shocked if they used cardioversion on you with a heart rate less then 180 so dont worry, I think your cardiologist was trying to scare you.

While A-Fib can cause serious problems it is also fairly easy to treat so dont let them get ya to scared. Take your meds as prescribed (probably some form of Digoxin and a Coumadin and MAYBE a beta blocker) and you'll be fine.

Thanks all, for your support. I'm on Coumadin and Cardizem. Getting suck everyday for my INR (Coumadin levels, making sure "I'm therapeutic"). I believe many people who lie about their intake is because they don't want it written down anywhere it may come back to haunt them. Listened to my heart this morning with my stethoscope (I used to work at a hosp. repairing many medical instruments and one followed me home.) and it sounded weird. Not like I'm used to.

I saw A Fib and I thought a Lie... Then I read about the Dr Visit and I'm thinking of the times I always tell my Dr the Fibs about drinking and eating BWW. Way more serious stuff here. Sucks. I need to get back in shape so my heart beats for a little longer.

I'm glad to hear you caught this early on and shared it with us! Makes me wonder about my own daily intake...

here i just thought you were from Illinois.

glad you caught it in time.

Pumbaa said:

I'd be very shocked if they used cardioversion on you with a heart rate less then 180 so dont worry, I think your cardiologist was trying to scare you.

While A-Fib can cause serious problems it is also fairly easy to treat so dont let them get ya to scared. Take your meds as prescribed (probably some form of Digoxin and a Coumadin and MAYBE a beta blocker) and you'll be fine.

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Cardioversion is used to correct the A-fib and send the heart back into sinus rhythm. BPM is irrelevant. I've had this done more than once.

To the OP, depending on the root cause of the arrythmia, meds should work. But not always. It's something you'll learn to deal with.

On the bright side, my cardiologist told me a couple weeks ago that one of his patients, age 71, just finished a climb of Kilimanjaro - while in A-fib.

Maybe a switch to wine is in order......
http://www.telegraph.co.uk/foodandd...improves-quality-of-life-for-middle-aged.html

I was working in the yard today trying to get some bags of topsoil to fill in where I had a tree stump ground down yesterday. On the 30 th. bag (I didn't think anyone would deliver less than 5 yds of topsoil), I sliced my finger with a utility knife. I thought I would bleed much more than I did, but it was a shallow cut. I used to drink more wine then when I started homebrewing, I switched to about 90/10 (beer/wine). I've said this before, if people who brew beer are brewers, does that make people who make wine, wine-rs?

Winemakers or Vintners. By your logic we would be called beer-ers hehe (which I am totally fine with)

Be careful shaving on the blood thinners. I had a boss that was on them for a clot. He cut himself shaving one morning and he said it took him over an hour to stop the bleeding.

motobrewer said:

here i just thought you were from Illinois.

glad you caught it in time.

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Ha!....You said FIB.

petey_c,
Without being intrusive, how old are you? I will definately be scheduling a physical for myself.

Pumbaa said:

While A-Fib can cause serious problems it is also fairly easy to treat so dont let them get ya to scared. Take your meds as prescribed (probably some form of Digoxin and a Coumadin and MAYBE a beta blocker) and you'll be fine.

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Hate to debate medications on a beer forum (you know whats coming next) BUT digoxin is nearly NEVER used anymore. I hate for medical misinformation to posted on the web so wanted to clarify current recommendations in medical profession with regards to medication and a.fib.

The current evidence supports use of rate control drugs (either calcium channel blocker such as diltiazem or beta blocker such as metoprolol) but NOT rhythm control drugs which often have worse side effects or causes other more serious arrhythmia. Digoxin can become toxic and probably does little more than less toxic rate control drugs previously mentioned. People with A.fib go in and out of arrhythmia and rarely continuously stay in that rythm.

When heart is in atrial fibrilation, atrial chamber is compressing so rapidly it never fully compresses to eject all the blood. Since blood is not moving as fast as it should it can form a clot. If the clot escapes the heart the first place it will go is to the brain causing a stroke. Because of this anticoagulation is recommended to prevent a clot from forming.

Not everyone gets the same anticoagulation, usually coumadin (warfarin) is recommended but low risk patients are thought to be just as protected by aspirin 81mg a day. A tool called CHADS2 is used to estimate risk for stroke in patinets with A.fib. You get a point if you have CHF, Hypertension, Age>75yrs, diabetes and 2 points if previous stroke. If score is 0 or 1 then you may only need to take aspirin to get the same risk of stroke and lower risk of bleeding side effect. Consult your cardiologist if you think you are in that category.

There also are a couple newer drugs that don't requiring INR lab monitoring that is needed with coumadin. IMO the better out of the two new ones is Xarelto (rivaroxaban). There is also Pradaxa (dabigitran). Neither require monitoring that is needed with warfarin but may have higher risk for bleeding than coumadin and since they are new we may learn about nasty rare side effects in a couple years that aren't known at this time.

Alcohol use is a risk factor for a.fib and other cardiac problems but not at the amounts you report your drinking (although if your 2 drinks a night is 24oz 10% ale then who knows). Moderation of alcohol is also important if your taking any of those meds (mostly so you don't fall while in a drunken stupor and bleed out).

Sorry to long-post slightly off topic but wanted to share what my best understanding of topic from the perspective of a pharmacist who has worked in anticoag clinics and reads the updated CHEST guidelines. Obviously your situation may be different and you should seek advise from your cardiologist to make any decisions regarding your care/treatments.

maddad, asking how old I am is not very intrusive at all. I'm 52... until Sunday.
megalomani, thanks for the insight. I go to see my cardiologist on July 13th. The week prior I have to wear a Holter for 24 hrs.. Right now since I'm a noob cardiac patient ("Do you think my heart is ruined?" post?) I'm still trying to do some research. I'm trying to moderate (4 oz. of coffee a day and lower beer consumption). I'm also going to start to alter my diet to a more heart healthy one. My cholesterol was a little high 234 and LDLs 154. Like the docs said you don't want to alter your lifestyle too radically too quickly.

petey_c said:

maddad, asking how old I am is not very intrusive at all. I'm 52... until Sunday.
megalomani, thanks for the insight. I go to see my cardiologist on July 13th. The week prior I have to wear a Holter for 24 hrs.. Right now since I'm a noob cardiac patient ("Do you think my heart is ruined?" post?) I'm still trying to do some research. I'm trying to moderate (4 oz. of coffee a day and lower beer consumption). I'm also going to start to alter my diet to a more heart healthy one. My cholesterol was a little high 234 and LDLs 154. Like the docs said you don't want to alter your lifestyle too radically too quickly.

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I turned 40 this year and have been somewhat aloof when it comes to health and age. I am not feeling invincible anymore. Your post has encouraged me to go get a physical. I am sure I will be joining you soon on altering my lifestyle. I wish you the best with your condition and new found lifestyle. Keep is updated. Oh yeah, happy belated bday.

maddad, Had to wear a "holter "monitor for 24 hours. Think portable EKG machine. The tech said don't allow the transducer leads to become disconnected, otherwise it will erase all the info. All was good until I woke this morning. I found one of the leads glued to the inside of my shirt. I lost six pounds at the hospital, thanks to hospital food and proper portion size. (We don't use portion sizing at my house, unless it's a plate full.) I've managed to keep four pounds off. Belated thanks for the belated birthday wishes. Pete

Had a visit with the cardiologist yesterday. He gave me two options; Go for the electrical cardioversion and try and zap my heart back into a "rhythm au natural," or stay on the blood thinners and Cardizem and see if my heart "converts" on it's own, if not, zap my heart. I opted to go for the proactive approach and get zapped around the beginning of Aug..

Getting zapped is not a big deal. Why are you waiting until August? Do it on Tuesday.

Art, I'm almost out of sick leave at my regular job, so I have to wait until then. If I get it done on the 3rd, I'll have three days off after. Plus my cardiologist suggested we do it (I'm the one getting "done") in about two weeks. I'm also a licensed electrician, so I'm used to getting zapped.

I assume you're not taking three days off for recovery. The only "recovery" is waiting a few hours for the MJ juice to wear off.

Art, my cardiologist wants four weeks of INR readings in the 2.0-3.0 range before surgery. That now puts me in the middle of August. I'm okay with it. I started running again (with the Cardio's approval) and I'm starting to relax a little more. My 17 y.o. daughter is; A) going to FL. with some of her friends Sunday and B) going off to college in Aug.. She's the first one to leave the nest, so my wife's "sweat pumps" are working full bore.

petey_c said:

Art, my cardiologist wants four weeks of INR readings in the 2.0-3.0 range before surgery. That now puts me in the middle of August. I'm okay with it. I started running again (with the Cardio's approval) and I'm starting to relax a little more. My 17 y.o. daughter is; A) going to FL. with some of her friends Sunday and B) going off to college in Aug.. She's the first one to leave the nest, so my wife's "sweat pumps" are working full bore.

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Ah, the coumadin thing. Forgot about that, now it makes sense.

Tell him you want Pradaxa instead.

Well, got the date; Aug sixth.

Well, going in this morning at 10. A little thirsty since I wasn't allowed to have anything to eat or drink from midnight on. I'll have a victory beer if all is successful, or a consolation beer if not... Pete

Stay in good spirits, it will be a breaze.

Hope all goes well.

My first time in the hospital with a-fib was Nov 2009 then again Jan 2010. I self converted both times but the doc recommended ablation. Had ablation in April 2010. I still have Arrhythmia but keep it in check most of the time with drugs. I no longer drink caffine and *try* to limit my alcohol intake. Those times when I drink too much does cause me some fluttering. Otherwise it's business as usual and no restrictions. Hope you get this in check with few problems.

Ah heart issues, I remember it well.

Thinking of you this morning!!!!!



I don't know if clinking beer mugs are appropriate, maybe this instead.

dzzzzzt

Yeah, thanks for all the heart felt "sediments." All went well. I was out in the garden this morning, pre-procedure to pick some tomatoes for later on in the day. Hadn't eaten or had any fluids since 10 pm the night prior. Saw a couple of cherry tomatoes that were calling my name. Popped them in and realized, "Oh schist. I wasn't supposed to eat anything"... The anesthesiologist almost made me wait an additional 4 hours. Rules are no eating 6 hours prior. She gave me a wink and back dated the time a couple of hours. Went into the procedure room at 12:30 and was waking up in recovery about 35 minutes later. Went out with SWMBO for lunch and as I keyboard (type?/speak) I'm in regular sinus rhythm (for now).

Revvy said:

Ah heart issues, I remember it well.

Thinking of you this morning!!!!!



I don't know if clinking beer mugs are appropriate, maybe this instead.

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Rev, When this originally happened I was going to make a message for my answering message that had the typical heart rhythm in the background and then when asked to leave your name and number, it would be the flat line sound. SWMBO didn't think it was as funny as I did...

Back in for cardio-version II Nov. 15. Ver 1.0 lasted about four weeks to the day. If my blood thinner levels were "therapeutic" (INR between 2 and 3) they would've shocked me right in the ER.

Make sure if they keep you on coumadin that you wear an alert bracelet or necklace or one of the other various med alert ID things. It could save your life if you ever get into an accident or something where you are unresponsive.

Hang in there petey. Hope this one gets you a regular beat that lasts.

rs, yeah that's not a bad idea.

+1 to med alert bracelet. Keeping a list of your meds in your wallet is a close second.