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Monday, March 13, 2017

StopAfib.org Postings!


When I thought how my running career would probably end, I expected it to be an orthopaedic problem, not an issue with my heart! Surprise! When I was getting spine and knee surgeries, I visited those sites that had blogs about procedures I was considering to get some real patient experiences. What I found, is that people who had success, the great majority, soon disappeared from those sites. Those that remained were the ones without success. Lately I have been reading and posting on StopAfib.org, and in similar fashion, those that I am communicating with are those with more complex Afib issues that they have not been able to be easily corrected.
It was exactly 4 weeks today from my Afib ablation. That is a third of the way thru my blanking period. I have gotten absolutely no resolution from the procedure, nor from two different medications that I have tried. There is a third medicine that I will try from my formulary when I see the EP doc on the 31st, while I am getting the small device embedded in my chest to follow my pulse for the next three years. There are folks that have tried 5 medicines, 5 or 6 ablations, 10 diversions both chemical and electrical, and lots of folks who finally relented, had their AV node ablated and a pacemaker installed. I am considering one more ablation if I get improvement from this current one, but if not, want to move to the much more invasive mini maze surgery from a thoracic surgeon. I will not make ablation a freakin' hobby. Don't have that many years left. So, the beat goes on....just irregularly!

Friday, March 3, 2017

A Very Scary Chart!

 This is a very scary chart on lots of levels. First, look at the current debt to GDP. Servicing the debt at 2 1/4 percent interest is manageable......serving it at 6+ percent would be catastrophic! Now, if you had greatly enhanced GDP growth and a serious attempt at debt servicing, you could avoid a calamity.  Doubt that will happen though. Looking at 3, 5, and 10 year earnings growth shows that we have climbed precipitously high in the market based almost exclusively on cheap money from the fed. If you look at personal/corporate debt, corporations have a lot more options to handle it including buy backs, dividend cuts, and secondary offerings....families, not so much! Cutting taxes may give GDP a boost, but certainly won't help federal debt, and I doubt would be a moment where families can afford to service their own debt. Add 40 billion potentially for a useless wall and God knows what for the military and a big infrastructure program, and this could all get ugly in a new york minute. It just seems that we are in for a decade of really subpar growth, a market that is substantially overpriced, and ripe for one of those black swans swimming bye......

Tuesday, February 28, 2017

Two Weeks Post Ablation!



Well, it has been two weeks since ablation. Symptoms the last few days are actually worse. Cardiac EP was surprised that I did not get some improvement to date, but everyone is different. Most high volume ablation centers post that they ignore any A-fib episodes for the first 8 week blanking period to allow the swelling in your heart to subside, and to see if the scarring covers the spots where the crazy cardiac firing is occurring. From reading blogs of ablation patients, many get much worse the first month before they get any better. In the mean time, I am awaiting UPS to deliver a temporary telemetry device that is about 4 inches bye 3/4 inch that you stick on your chest to send your heart data to the docs. They want to see if your A-fib is improving at all. On March 31st, they will implant the device pictured above under my skin above my heart. It is about 3/4" long and the thickness of a pen barrel, and is highly sophisticated. It reads 24/7, downloads data to your doctor weekly, and reads for up to three years. It also tells them how much of your day, your percentage, you are spending in A-fib to see where you are headed. It leads me to believe I am in this for the long haul! So the progression of this process would possibly lead to another ablation, a mini matrix surgical procedure, and finally a procedure where, if all else fails, they burn off your main cardiac signal node and put a pacemaker in you. That is the last resort end game. So, will I ever get to run again, who the fuck knows. Add to that, I go in march 9th to see Murphy about getting a CT scan to see about the spot on my lung discovered during my ER visit from February 16th. So, it is a lot to deal with now, and I have that wonderful feeling of powerlessness that comes with things your body does that you have no control over. So, all I can do is wait and see, and I am not the most patient person with that......

Saturday, January 14, 2017

A-Fib Monologues Deux!




Saw this yesterday evening on seinfeld rerun.....always loved it, but didn't quite understand it. From a real court case in Australia, and an early movie from Meryl Streep!
Saw the electrophysiologist cardiologist in El Paso on Thursday, and we will move ahead with the ablation procedure. The February schedule is not set up as yet, so they will call early next week to schedule me. These 2 guys just do a damn shitload of these and cardiac device implants. So, I will get in when I can. Not looking forward to the procedure itself or the first few days afterward, but will find out if I am on the right side of a fifty fifty coin flip. Would do it twice if needed, and if that didn't work, would be stuck just living with it. Sure miss running and weights as I am reduced to an hour walk each day.....but, such is life......gotta just do my best to accept the results and learn to roll with the punches........

Wednesday, January 4, 2017

The A-fib Monologues!

So on Tuesday January 3rd, I kicked off 2017 with an electro cardiac diversion. Fun stuff. They make you stupid, as apposed to knocking you out, and then stop your heart, hold a second, and then fire it back up. Felt the shut down, and the start up was like a mule kick. Deb brought me home, and about four hours from being shocked, I slowly started to rebuild the A-fib....a few short bursts, and within about three hours, right back to where I started.  Didn't sleep well last night as the two pad sites where they shocked me are burned and itch like crazy. You can see a nice outline of the two pads on my chest! Maybe they will try leaches next! What the hell. So today, I called to try and get the damn ablation scheduled. Instead, I have to go back to El Paso on Thursday the 12th to go over the diversion report, whatever the hell that means, and again discuss trying to get to the ablation. Feel trapped in a loop between two cardiologists and the wonders of medicare treatment protocols. Drives me freakin' nuts. As Terrible says, they have to create as many payment points as possible to get as much money out of medicare and humana as possible. Probably right. So I guess I will just keep walking every day and continue to take toxic medicine and try to keep myself from turning psycho when I see the ablation doc next. 
One of the crazy things about this experience, is that after reading the haywire heart, I blamed myself for those 800 or so races and 75,000 plus miles for being a primary factor in bringing this stupid crap on. While I was getting shocked like a monkey, Deb happened to post on facebook that I was in getting the procedure, and within an hour, every damn cousin from Di Mannen, Jack Mannen, and Mary Mannen Doverspike posted that they have freakin' A-fib, or still have A-fib. They run the gamut from almost all who have had electro cardiac diversion or chemical diversion, and ablation. My younger cousin Dennis had both diversions, chose not to have ablation due to problems his sister Joan had from her femoral insertion site in 2005, and has been in permanent A-fib for over 20 years. And of course, my Grandpa Mannen had multiple strokes in his early 50's and died before turning 55, probably due to this family rhythm problem and the strokes it can produce. Awesome! So, no more kicking myself in the ass for my lifetime exercise history, as I was probably doomed to have this at some damn point, and I actually held out much longer than many of my relatives.....you just can't run and hide from your genetics.....

Wednesday, December 21, 2016

A-fib Diaries!


If the browns lose out, they could tie the lions as the only 16 game winless team in NFL history....quite an accomplishment!
I know it has been a while since a posting, primarily because I needed to educate myself before taking on this  topic. On Nov 7th, I went into persistent A-fib. Didn't know I was in it. Just knew something was terribly wrong with my pulse. I normally take about 20 minutes of running to get into the 120's on heart rate, and unless doing speed work, stay generally below 130. I would run a quarter mile and have a HR of 135, and a half mile later, 155. Had to stop and walk, and it wouldn't drop below 120 in recovery. Thought maybe I was getting the flu or something. On my 65th birthday, I was seeing my GP for the results of some tests and to redo scripts, and after doing an EKG, he immediately sent me over to a cardiologist who told me I was in A-fib. He did an echo cardiogram and said that I had both A-fib and arterial flutter. So both the right and left chambers of my upper heart were beating iradically. He immediately put me on xralta, a blood thinner, to reduce the risk of stroke. Since then, I have seen him and another cardiologist in El Paso, and researched my ass of about this condition. I have some congenital genetic heart issues that helped set this up. It is a progressive disorder that must be addressed, or it will take a good 5 years or so off of your life. The protocol ahead is as follows. I started a rhythm medicine yesterday that I will take for two weeks ahead of Electric cardio version that is scheduled for Jan 3rd 2017. At that time, they will attempt to use shock to restore my normal sinus rhythm. Odds of this working are almost 100 percent. Problem is, that staying in rhythm is incredibly variable. You can be back in A-fib before you even wake up, or stay in rhythm for a more extended period. Problem is that only about 12% of people stay in sinus rhythm a year out, because the causes of the A-fib have not been addressed. I will remain on rhythm medicine after the cardioversion. The bad part about these medicines is that they all have very nasty side effects, so you don't want to remain on them for too long a period of time. My treatment plan calls for catheter ablation about a month after cardioversion. This procedure places a catheter camera combination into a vein up into your heart where they attempt to burn about 40 sites in your heart to stop these aberrant electrical signals from interfering with the normal signals that run your heart. I jokingly call it the Peyton Manning effect....you are trying to stop him from yelling "Omaha Omaha" and trying to change the play. The procedure takes about two hours, and leaves you feeling like a horse kicked you in the chest. There is a period of three months where you find out if it worked or not. This is how long it takes for the scarring to settle in to stop these nerve firings. Chances are around 60% that it will resolve your A-fib. If not, you can have the procedure done again, and that usually gets you to a resolution of around 85-90%. If that fails, there is a surgical procedure called a mini-matrix process, and then ultimately failing all that, a pacemaker. So that is where I am at. No running or weight lifting for a while, just some daily walks. Feel trapped inside my own body. As the smashing pumpkins once sang, "despite all my rage I am still just a rat in a cage"!

Monday, November 21, 2016


Two weeks ago today, I got home from the gym feeling a bit odd. Chest was tight, and felt unusual. On the next day, I went out to run, and within 200 yards, my pulse on my garmin was around 134, and within ten minutes, over 150. Now normally on a run it takes me about twenty minutes to get my heart rate above 120, and I have to push really hard to crest 150. So I knew something was odd and I quit after about twenty minutes. I hit the gym a couple more times, and tried to run, but nothing was working quite right. On my birthday last Monday, I had an appointment to give blood and see the skin doctor, After I gave blood, I asked to see my doctor for a minute, and he saw me and I explained my problem, and he did an EKG. He scheduled me for later in the day for a visit to the cardiologist. When I got there, he gave me an echo cardiogram and said I was in persistent A-fib. Persistent means for longer than 48 hours. My upper chambers were beating three times as fast as my lower chambers. He put me on blood thinners to try and prevent a stroke, and scheduled an appointment for Nov 28th for another EKG, and if I am still in A-fib, will follow up with an electo cardiac diversion where they stop your heart for three seconds and then restart it to try and get your sinus rhythm back. This generally works almost all the time....the problem is that it doesn't necessarily last very long. There is an 80% chance that you will return to A-fib within an hour to a year. If that probability occurs, the next step, which is about 85% successful is ablation, where they put a catheter inside your heart and burn the nerves and tissue that are trying to take over your heart's normal rhythm like Peyton Manning yelling "Omaha Omaha". If I need that procedure, there are two places in the world that do the most.....Penn hospital and Cleveland clinic. I will head to Philly and Billy and Kwonnie for the procedure. I have two issues that make it doubtful that the A-fib will remit for long after diversion.....my left atrium is 6.2 centimeters, and when it grows over 5, A-fib usually arrives. Second, the right side of my heart is small either from congenital reasons or having rheumatic fever as a child. In the mean time, taking short walks, eating my blood thinners, and just taking it generally easy until I get shocked to life. Will be on blood thinners for a month after the procedure, whatever the outcome. If the A-fib returns, want to get to ablation as soon as possible, as the longer you screw with this, the more your heart tries to model in such a way that these signals are perceived as normal.....want the Peyton of my heart to also retire!