THURSDAY WHATEVER

On March 11, 2008, I presented at my PCP’s office for my annual physical not feeling that well. I’d been dizzy for days and fighting off what I thought was a minor sinus infection. I’d been through a course of Augmentin for 2 weeks with no major improvement and then was handed a scrip for Avelox, an antibiotic in the fluorquinolone family like Cipro, which had made me deathly ill with faintness, gastritis, nausea, vomiting, and which I had stopped after three days. The dizziness I thought might be due to BPPV (benign paroxysmal positional vertigo), which I’d had a bout of two years previously and had been told might return one day. I thought I was going to ask for an Epley maneuver which is a positioning movement that jars loose the little crystals in the ear canals that cause BPPV. Instead, after the usual listen to my heart that comes with all physical exams, they trotted out the EKG machine and hooked me up. My heart was racing over 100 bpm and I was told I now had atrial fibrillation, the “most common” of all heart irregularities. Apparently, an allergic reaction to Avelox was the culprit. To make a long story short, I was immediately put on a beta blocker (medication to reduce the heart rate) and Coumadin (a blood thinner – used for rat poison too I found out later) to keep me from forming a blood clot that might cause a stroke. Referred to a cardiologist for an echocardiogram, nuclear stress testing, and 48-hour Holter monitor, I learned that my heart was otherwise healthy and recommended to have a cardioversion (procedure to shock the heart back into normal rhythm). I transferred my care to a different cardiologist trained in electrophysiology, because he specializes in Afib. He did the cardioversion on June 6 (it took that long to get my blood thinned to the proper range so I wouldn’t throw a clot during the procedure). For one whole weekend I remembered how it felt to be in normal rhythm and then on Monday morning woke to find I was back in Afib, apparently for good. In the 7 months since the first shock of going from excellent health to a future of dealing with this condition permanently, I’ve learned more than I ever wished to know about the heart and stroke and major lifestyle changes. Afib is an electrical aberration in the heart. The two top chambers go haywire, firing off in random patterns so that the usual blood flow of the heart is disrupted and tends to pool in the lower part of the heart, thereby threatening clot formation. The one great luck for me in all this is that I had no other risks like diabetes, high blood pressure, high cholesterol, etc. But on the flip side, I’m in the smaller portion of Afib patients who go immediately into persistent fibrillation, instead of going in and out of normal rhythm like most folks do. Recently, the news has mentioned that both Dick Cheney and Joe Biden have “paroxysmal” Afib. Those people go on to try other procedures and surgeries and anti-arrhythmic drugs that sometimes bring long-term cures, but mostly not. In my case, after the one failed cardioversion my EP says the risk of those other options is more than it’s worth for me since I’m as healthy as I am and relatively asymptomatic. (After a month of dizziness and a month of chest pain, I mainly have less energy than I used to.) Therefore, the plan is for me to stay on “rate control” with the beta blocker and thank god go off the Coumadin (which makes one an easy bleeder) to use 325 mg aspirin/day. Forever. Unless there are miraculous developments in the coming years. So that’s where I’ve been dear xangans who still show up at my page or arrive in the future. Life on life’s terms. Once I got over the Major Shock in the beginning, I began to dig out – using therapy, acupuncture, relaxation tapes, online support forums, and big improvements in diet and exercise. It hasn’t been a fun ride, but it could be so very much worse. Onward.