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reno
Jun 15, 2006, 11:36 PM
Post #26 of 37
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Registered: Oct 30, 2001
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In reply to: thanks, Reno, for that useful answer. is it based on personal experience of the condition or/and are you a medic?
I'm a flight paramedic, and I also work in the Cardiac ICU at one of the local hospitals.
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robdotcalm
Jun 16, 2006, 4:30 AM
Post #27 of 37
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Registered: Oct 31, 2002
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Here’s an anecdotal account of my atrial fibrillation (AF) and that of my younger son, Dan for whatever use it may be for the OP. As a teenager in the 1940s, I had regular bouts of AF but was never really inconvenienced by them and assumed everyone’s heart fluttered now and then. Years later I was diagnosed with a heart murmur and WPW (Wolff-Parkinson-White syndrome) of an odd type. Since there was nothing anyone could do for it in those days, either medically or surgically, it was ignored. Usually, the AF would convert to normal beating within two minutes. A couple of doctors told me it would lessen as I got older as a result of decreasing levels of testosterone and adrenalin (I have no idea if there is a factual basis for this assertion). Anyway, I engaged in physical activities that were stressful such as football, basketball, weight lifting, and track events such as the 120 high hurdles and the half-mile. The AF never bothered me during such activity. It would occur more often when I was resting.
Dan started having AF in his early teens as well as being diagnosed with WPW. From the start his episodes were more severe than mine. They lasted longer and made him feel sick. Three times we needed to take him to emergency room where medications were infused to convert the AF. He was put on beta blockers, which controlled the condition. In his late 20s, he went off the beta blockers on his doctor’s advice and did not have further bouts of AF. In his mid-30s, he developed a severe bout AF one evenng. His wife took him to the emergency room at Baylor Medical College in Austin. As they walked through the door, he collapsed with ventricular fibrillation (VF). They immediately electro-shocked him with the heart beat returning to normal. The next day he had radio-frequency ablation in a closed heart surgical procedure to interrupt the extra conducting pathway causing AF. That was in 1997. He has had no further bouts of AF. The conclusion was: he had eaten a restaurant meal that had led to diarrhea, which caused low blood potassium leading to AF setting off the VF. He was very lucky. A couple of minutes of VF usually leads to permanent brain injury and more than a couple of minutes to death. If he been playing golf or fishing, he would most likely have died. Strokes from AF are not the only thing to worry about. If it leads to VF, death or worse are the most likely outcomes.
Also, in 1997 my heart murmur was diagnosed as being due to a faulty aortic valve (2-leafed instead of 3-leafed) and which had become stenotic. It was replaced in open heart surgery with a bovine prosthesis. It took me about 9 months to get back to climbing, but I’ve had no problems since then and need no medications. An alternative to the bovine prosthesis was a plastic valve. It might last longer, but it would have required me to be on coumadin. 3 different cardiologists said that climbing of any sort, even indoors, would be forbidden if I were on coumadin. One good bang and I could have a serious bleeding incident. One even mentioned that he would not want me to hike, “You trip and bang your knee and you could bleed to death.” All of them very strongly recommended (actually insisted) that given my life style, I get a valve that didn’t require coumadin. I’m grateful for their understanding.
That same summer of 1997 one of my colleagues in his late 50s developed AF in the early morning. It led to VF. He was dead by time the ambulance arrived.
Cheers,
Rob.calm
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slarsen47
Jun 16, 2006, 5:33 AM
Post #28 of 37
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Registered: Jun 16, 2006
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Atrial Fibrillation is a potentially dangerous condition especially if left untreated. In my case it led to a blood clot.
I suffered a stroke 1.5 years ago (age 56), went in to hospital with loss of speech. Was extremely fortunate to have been with my wife at the time who immediately recognized the symptoms and rushed me to emergency where I was given TPA (following a CAT scan to first check for cerebral bleeding). I made a full recovery within a couple of hours with absolutely no deficits. One of the lucky ones i.e. close to someone who recognized symptoms and close to a hospital with doctor administering TPA.
It was determined at the emergency room that I had atrial fibrilation. I have no sensation of being in AFIB or SINUS rhythm. Have always had regular checkups, donated blood, non-smoker, social drinker, active and normal weight..........the atrial fib comes and goes.......how long I have had it.......who knows.
In my case the basic treatment is anti-coagulation with Warfarin (coumadin), altace and atenolol.
Without anti-coagulation therapy you are running the risk of a clot. It is true that there is a greater risk of bleeding. The key is to maintain the INR (lab measure of blood coagulation) within the prescribed limits.
The consequences of stroke are potentially life altering for both you and the people that are close and have to look after you.
I continue to do the things I did before the incident, but am more deliberate about not taking chances which could result in a fall or receiving a hard blow to the skull.
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questor
Jun 16, 2006, 6:29 AM
Post #29 of 37
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Registered: Jun 14, 2006
Posts: 28
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In reply to: Here’s an anecdotal account of my atrial fibrillation (AF) and that of my younger son, Dan for whatever use it may be for the OP.
Thanks for taking the time to post this very full account. I'm glad the medics found a suitable solution for you in the end. It seems that there is some hereditary basis for your son's condition, from what you're saying?
Luckily for me, i have no underlying structural heart defect. Bearing in mind my young (for the condition) age of 42, and that there's no heart defect, my cardiologist took the view that sotalol alone will be fine for me and that there's no need for me to take coumarin. i did stress in the hospital that taking warfarin/coumarin for the rest of my life and suspending all my outdoor activities would be very tough, if not impossible for me to comply with. i think i was lucky to have someone prepared to consider my lifestyle factors and decide that i'd be at a greater risk by not complying.
my two episodes so far have been severe and sustained, lasting 48 hours and 24 hours respectively. i can't work out a trigger, but it's interesting that last time, i was asleep after completing two difficult (for me) and long (8 hours ) climbs in winter with a long walk in.
hopefully sotalol will prevent a 3rd episode.
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questor
Jun 16, 2006, 8:24 AM
Post #30 of 37
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In reply to: In reply to: ...Atrial Fib can be precipitated by various factors: Electrolyte imbalances, fatigue, drug use, medication use, diet, dehydration, etc... ... learn to pay VERY close attention to your body...
very interesting. none of the medical staff who've treated me has really offered an explanation, nor really paid heed to the background i've given them. i think they eliminate structural defects first (complete), then lifestyle factors (complete) and then start looking more closely at the signal-generating tissue of the heart.
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questor
Jun 16, 2006, 8:29 AM
Post #31 of 37
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In reply to: If it leads to VF, death or worse are the most likely outcomes.
death, i understand.
'death or worse', however, is a challenging concept! :wink:
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boo
Jun 16, 2006, 12:52 PM
Post #32 of 37
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chezdillon
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robdotcalm
Jun 16, 2006, 3:38 PM
Post #33 of 37
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In reply to: In reply to: If it leads to VF, death or worse are the most likely outcomes. :!: death, i understand. 'death or worse', however, is a challenging concept! :wink:
Before my open-heart surgery, the surgeon interviewed me. He said, "The worst possible side effect of the surgery is a stroke. The next worst is death on the operating table." I asked him if the first occurred could he convert to the second worst. He said, "No."
Does that explain it?
Cheers, but not cheerfully,
rob.calm
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robdotcalm
Jun 16, 2006, 3:40 PM
Post #34 of 37
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In reply to: In reply to: If it leads to VF, death or worse are the most likely outcomes. :!: death, i understand. 'death or worse', however, is a challenging concept! :wink:
Before my open-heart surgery, the surgeon interviewed me. He said, "The worst possible side effect of the surgery is a stroke. The next worst is death on the operating table." I asked him if the first occurred could he convert to the second worst. He said, "No."
Does that explain it?
Cheers, but not cheerfully,
rob.calm
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jabtocrag
Jun 16, 2006, 5:11 PM
Post #35 of 37
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Registered: Apr 22, 2003
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In reply to: very interesting. none of the medical staff who've treated me has really offered an explanation, nor really paid heed to the background i've given them.
I feel ya there. Throughout my 20s, I've had a couple major episodes (it sounds like my major episodes are simlar to yours...very debilitating) of afib that threw me into the hospital. Shitty experience overall, but luckily, I always converted on my own and had no lasting side effects. I've also been plagued with a large number of minor episodes over the years that I've always let pass without action. Perhaps due to my age, general health and frequency of major occurrences, I'm not on any meds, don't have a pace maker and haven't undergone any surgery for my condition. I was pretty much told that we need to keep our eyes on it. If it gets worse, I'm sure something will need to be done, as stroking out is the most horrific side effect of prolonged afib.
What I've learned is that the docs who treated me, plus all the docs I know personally, don't really have any clue what causes my afib (i.e. afib in what appears to be a young, healthy person with an otherwise healthy heart). From empirical observation of my condition, I've come to the conclusion that I think stress has a great deal to do with it, but I doubt that's the only cause. I try my best to limit stress in my life and I'll continue to keep my fingers crossed...for both me and others with this condition. Good luck to ya!!
Justin
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quicksilver52
Jun 22, 2006, 12:00 AM
Post #36 of 37
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I had a serious heart attack in Oct. 2000 and found out that I had a previous heart attack six years earlier that I just sort of bounced by. While in the hospital recovering from a stent being placed in an artery I developed A-FIB. I lost about 1/3 of my heart and that is probably why the A-FIB came on. It was very difficult at first and I would go in and out of A-FIB and the time would vary from a couple of hours to a few days. Scared the shit out of me. After about three years of this I went into permanent A-FIB - which most articles I have read say is the normal course of events.
I tried to figure out triggers to the point that I suspected certain color socks could cause it. Sometimes I would be leadind a route and it would kick in - definitely a mind challengeing experience. Oddly enough while I wish I had no heart problems I find being in A-FIB all the time perferable over going in and out. My rate is reasonable and I am a lot less anxious since accepting that I am stuck in it. Some of my obsevations after dealing with all this and reading everything I can get my hands on about A-FIB.
1) Rythmn control drugs are loaded with serious side effects and overall do not work.
2) In the AFFIRM study the general concensus is that the medical outcome is the same when comparing rate control vs. rythmn control and rate control drugs are much safer.
3) For some reason even though this seems to be the case Doctors still tend to push Rythmn Meds.
4) Since you have an otherwise healthy heart, ablation would seem to be a resonable choice but there are no guarantees and peoples posts on their experience with this procedure seem to be conflicting with the medical literature at times.
5) The literature on A-FIB says that it is rarely life threatening and that stroke is the #1 concern. Blood thinners is the recommended treatment. I have been on coumadin for 5 plus years and monitor the INR on a monthly basis. I actually decked from 35 to 40 feet on lead (don't ask) and there where no blood related complications - was able to climb the next day. However the fall did demonstrate definitively that you can get your ass and testicles to turn purple and it is true that you can have the shit knock out of you as I discovered at the hospital. I landed sitting down - a blow to your skull of much less force would be a different and serious matter - WHERE A HELMET !
Today I climb on a regular basis but try not to get in high risk situations.
I also mountain bike and go out a lot by myself - my motto is to always keep my bike under control - I'm old and slow anyway. I swim and also do light weight lifting. Sometimes I feel weird from the A-FIB but it passes.
I am lucky with my rate and I take several meds - two ACE inhibitors instead of beta blockers - was on Sotalol and it kick my butt and scared me - read up on it and see if you think it works - I do not think the literature supports its usefullness in A-FIB. I may die someday while climbing or biking but I love it and never feel better then when I am doing those things. Also I belay with a GRi-GRI just in case and make sure if I am with new people that they are aware of things in case I act weird or something.
One interesting note - when I was going in and out of A-FIB I use to jog ang it would put me into normal sinus rythmn either during the run or a short time later -I found people on the A-FIB forums who did this and it was referrred to as the BRUTE FORCE METHOD - Doctors will just grin if you tell them that but it worked. Had to quit jogging - knees could not take it and I am tierd of artoscopic surgery. Sorry to be so windy but it is good to vent as A-FIB can be difficult for people to understand because you look just fine to them. Best of luck and never give up.
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flamer
Jun 22, 2006, 12:24 AM
Post #37 of 37
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Registered: Oct 22, 2002
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DUDE!! When it happens just bare down real hard like you're taking a poo!!!
josh
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