Your ballroom days are over, baby
\nNight is drawing near
\nShadows of the evening crawl across the years…<\/p>\n
— from “Five to One” by Jim Morrison<\/em><\/p>\n A month ago today, I took my second ride in an ambulance.\u00a0 No sirens, no racing through the streets.\u00a0 In fact, it seemed like an incredibly slow ride.\u00a0 The only thing that was racing was my heart, somewhere in the 130s as I recall.\u00a0 Maybe higher.\u00a0 I don’t remember a lot of details of the ride — I was trying my best to stay calm and trust that the EMTs were doing what they needed to do to stabilize me.\u00a0 But I was scared as hell.<\/p>\n As it turns out, I have paroxysmal atrial fibrillation (AF).\u00a0 Paroxysmal<\/em> means that the AF spontaneously resolves on its own, as mine did during my hospital stay (with the help of some rate-control drugs).\u00a0 But as I learned from my cardiologist, people rarely have just a single episode of AF.\u00a0 As he put it, my next episode could be next week or next year, but he was all but certain that my AF will return.<\/p>\n Naturally, I have been doing a lot of reading about AF in the days since my scare.\u00a0 One of the most informative articles I found was Diagnosis and Treatment of Atrial Fibrillation<\/a> by Gutierrez and Blanchard in American Family Physician<\/em>.\u00a0 It spelled things out for me in extensive but readable detail.\u00a0 The basic treatment strategy is this: (a) assume the patient will return to AF at some point; (b) but note that rhythm-control drugs have side-effects and have limited effectiveness; (c) therefore, prefer to use rate-control drugs to keep the heart from racing and injuring itself during future AF events; and (d) use anti-coagulants to keep clots from forming in the atrium (and going to the brain) if-and-when AF recurs.<\/p>\n I was already taking a beta-blocker, which is a blood-pressure and heart-rate control drug (the doctor tripled my dose).\u00a0 But I am now also taking a so-called blood-thinner, which does not thin the blood per se but instead interferes with clotting.\u00a0 I was sent home with a prescription for Xarelto (once a day) but have since switched to Eliquis (twice a day) since there is less side-effect bleeding with Eliquis.*\u00a0 I read the research.<\/p>\n I am confident that my new cardiologist (not from our local hospital) now has me on the right course but he is still a bit mystified.\u00a0 You see, AF is my second heart-related problem. It exists (paroxysmally, for now) alongside my left bundle-branch block (LBBB) which is a type of heart-muscle signal-conduction failure.\u00a0 In essence, the left side of my heart does not get its own dedicated signal; instead, it has to “borrow” its signal from the right side.\u00a0 My LBBB was discovered in the aftermath of my first ambulance ride, two decades ago — but who knows how long I had it before then.\u00a0 What mystifies my new cardiologist is that I have been “walking around” with LBBB all these years and my heart is not in worse shape, to paraphrase his remarks during our visit.<\/p>\n It took me aback when he told me that — blood instantly rushed to the top of my head.\u00a0 If I may explain:\u00a0 After my LBBB diagnosis, it took me a good while to shake off the notion that I might suddenly drop dead.\u00a0 I wandered through a two-year-long panic-infused funk.\u00a0 So now, my cardiologist telling me not only that my AF will<\/em> get worse but that my LBBB should have been<\/em> worse was a one-two punch of cold sober.\u00a0 It stirred up some of the old panic-funk, which I have been trying to keep at bay since the visit.<\/p>\n The cardiologist has ordered a cardiac MRI to help resolve the mystery.\u00a0 I hope this will not deliver a third punch.\u00a0 We will find out more in a few weeks.<\/p>\n Meanwhile, I mourn the loss of some familiar friends.\u00a0 I can no longer take ibuprofen for headaches or sore muscles because of the bleeding risk.\u00a0 I can no longer eat grapefruit or cranberries because they interfere with metabolism of the anti-coagulant.\u00a0 I have had to virtually eliminate caffeine and alcohol, as both of these may trigger new episodes of AF.\u00a0 Goodbye happy-hour martinis, hello carefully-measured splash of bitters to add flavor to some club soda.\u00a0 That’s the way it is, as Walter Cronkite used to say.<\/p>\n \u2022 \u2022\u00a0\u2022\u00a0\u2022<\/p>\n I did debate whether to write and post this.\u00a0 In the end, I decided it had therapeutic value if nothing else.\u00a0 I know many others have more painful stories to tell, and this one stands somewhere way back in the line.\u00a0 I’m sure I will have a different perspective on all of this next week, next month and next year, but right now I’m just laying low, feeling an odd mix of carefulness, thankfulness and loss.<\/p>\n Thank you, Sue.\u00a0 Bear with me.<\/p>\n ___________<\/p>\n Your ballroom days are over, baby Night is drawing near Shadows of the evening crawl across the years… — from “Five to One” by Jim Morrison A month ago today, I took my second ride in an ambulance.\u00a0 No sirens, … Continue reading * Inexplicably, the hospital cardiologist sent me home with Xarelto, despite the fact that other doctors I saw in the hospital expressed their preference for Eliquis, as did my new cardiologist and my primary physician.\u00a0 The hospital cardiologist apparently decided that my taking one pill a day (Xarelto), instead of two (Eliquis), was well worth the higher risk of internal bleeding.\u00a0 Was I involved in the decision or informed of the risks before I was discharged?\u00a0 Of course not.<\/h5>\n","protected":false},"excerpt":{"rendered":"