Sunday, August 26, 2018
Since turning 65, I have certainly utilized Medicare beyond what I thought possible. In 20 months, have reached a gross billing of 1.3 million dollars. Keep fearing that I will wake up to find Paully "the rat" Ryan standing by my bed with a pillow in his hands. I have had a cardio version, two ablations, catherization, pacemaker placement, ICU hospitalization for cardiac tamponade from pacemaker lead puncture, three ER visits, two connected to the cardiac tamponade, cataract surgery with lens placement on both eyes, and recently 4 more skin cancer biopsies. Next on the agenda is a prostate biopsy in late September to determine if I have prostate cancer, and if so, thru a gleason score, weather it is a fast or slow growing variety. That helps decide if you need to address immediately and which treatment you may choose. Fun stuff.
Been back to jogging on the treadmill and lifting weights 5 days a week or so at the gym. Can slog thru 40-45 minutes on the mill. 2 of 3 times my heart rate will reset after 3 to 5 minutes and remain within what I consider a normal range of 118-125 BPM. On the third occasion, damn heart rate won't correct, and stays between 150-170. Those jogs are hardest because they are most fatiguing. Ready for cooler weather and doing it outside. Within an hour after each jog, my heart attempts to drop to a rate in the 30's (bradycardia), but the pacer kicks in and drives it back to the 70's or 80's. Afib has been reduced to less than a half a percent of the time, but still get periods where I feel a bit weak or dizzy. Just have to accept that going forward.
Heading to Ohio next Sunday for a couple weeks to see friends and the grand kids. Flight and car are arranged, and some of the stays. Will figure the rest out after the first week or so. Will be a nice change of pace from freakin doctors......
Saturday, June 16, 2018
Woody Allen once said "I'm not scared of dying, I just don't want to be there when it happens". After my near demise from pericardial tamponade, I understand that quote perfectly. Pericardial tamponade is where you get a massive buildup of fluid inside the sac around your heart that presses on your heart and attempts to stop it. Mine occurred from a small screw which was used to anchor the pacemaker lead into my atrium that punctured it. When I was last awake in the ER awaiting a decision on weather they were going to attempt to put a needle assisted drain in my heart or cut thru my ribs and open a drain window in the sac, I just wanted to be sedated and not be around for whatever the result was. I awoke with a drain port about two inches above my naval, and a bag full of about 10 ounces of blood and fluid. I ended up being drained for 5 days before it was safe to remove the needle. That felt like something from a horror movie where you see someones heart pulled thru their chest. Fun stuff. So to the surprise of my cardiologist, cardiac surgeon, and electro physiologist, die I didn't do. I had an echo performed last wednesday to see if any further fluid has accumulated. I will have to call in for the results, although the tech said it looked good. Also, I have a pocket hematoma of dried blood where the pacemaker was implanted, that I have to apply heat to 4 times a day to try and get my body to absorb it. Also fun stuff. So mentally I feel a bit fragile, and a bit non engaged in what is going on around me. Odd.....hope it ends soon. Also have had lots of crazy ass anxiety dreams. Hope that also ends soon.
When the Medtronic man saw me last to test that everything is in place and firing when it is supposed to, he told me that he thought I was held together by scars and tatoos. Haha....I think he might just be right. Lost 13 pounds during the 8 days I went from pacemaker implant to being released from heart sac draining. Got about 3 back, and in no hurry to get the other 10. My shorts fit comfortably again. Worst part of the aftermath, is I feel weak and dizzy. All the meds I have to take, and there were 4 new ones for a week or so, have dizziness and fatigue as the number one common side effect. That hasn't helped. I have walked for 40 minutes on an inclined treadmill every day since the second day after coming home. Hopefully will get over the standing dizzies and fatigue and start to garner some strength back soon. In the meantime, the assisted beat goes on......
Friday, May 18, 2018
On Wednesday they will finally put a pacer in me. Have been expecting this for some time. I will have the procedure at 2 PM mountain time. I will be awake for it. They will first open a vessel in my neck and feed two electrical lines down into my right ventrical and left aorta. They then do a small charge to see that conduction occurs and the lines are seated. Then they make a small slit under you collar bone, attach the lines, and test it. The last step is to slide the silver dollar sized pacemaker into the pocket under your collar bone, and sew it up. After that is accomplished, they will make a small pen sized incision in my pec to remove the loop recorder that has been in place for the past 13 months.
Not concerned about being awake for it. They give you stupid pills to relax you. Did that for the catherization. They need you awake so that if you feel any pain during any of it you can inform them. The hard part is another recovery. For two weeks, not allowed to raise my arm over my head or lift anything heavier than a milk carton. Don't know why they always use that analogy. Then I can at least do some walking for two more weeks, and then I am free to go back to any and all exercise activities. Doc said I wouldn't try to do heavy exercises or squats though, as this can push the pacer out of its pocket. I said look at me.....do you think I do that?
So that is that for now. This pacemaker will stop my bradycardia where my HR drops into the low 30's. It will be set somewhere between 50-60. Secondly, it will recognize the problem that appears often to trigger much of my afib, and that is PVC's. I have more of those than my current Afib load of around 1.5%. Thirdly, this pacemaker has something called reactive ATP which is supposed to reduce afib reactions, so all in all, am hoping this gives me some degree of exercise tolerance that I currently don"t have. The pacer battery should go 10-13 years, longer than I will be alive, is bluetooth encrypted/secured to allow them to use a smart phone to change settings, upgrade, and read data. Had to make sure Deb couldn't be able to shut me off with her iphone! So that is that!
Friday, April 13, 2018
Had Cataract surgery on my left eye with a lens implant on Thursday. Tender and a bit blurry yet, but no real pain. Worst part is another 6 days free of exercise and special care. Vision in right eye is 20/20, but this eye appears not to be quite as cooperative. 20/60 a few hours after surgery, and seems sharper today, but certainly not 20/20. Hope is to get to 20/30 and not need to have a contact in that eye, and escape the need for glasses other than readers for close up stuff.....
Heart remains another matter. Still have mild Afib, which in general is not bothersome, except it horribly limits endurance exercise. Heart rate does not seem connected to activity in any meaningful way, and my exercise tolerance is horrid. The other problem remains the bradycardia that occurs in the hour after the exercise ends, falling into the high 30's for now. Before last ablation, when 4 months of work got me to being able to jog 30-40 minutes, it dropped twice to 32 and 31, which does not feel very pleasant. I plan to see the EP after we return from Padre in late may to see where I stand. If the problem remains Afib, I would try one last ablation, but only by Dr. Natale, the nations best, in Austin Texas. If they determine that the problem is more with the AV node, your hearts computer that controls it electrically, I would push for a pacemaker implant to take over the electrical function. So for now, just gotta be patient and do what I can do.....gym and recumbent work fine, walk jogs suck, but I will keep doing what my heart allows..........
Thursday, February 1, 2018
My favorite song from the new Rick Springfield album.
Saw the EP today. First I had to put on a mask cause I foolishly listed that I had a cold/flu. Surprised I wasn't sent to a room to be washed down like a hazmat exercise....
The Medtronic dude came in first and ran all my data. afib is around 6 tenths of one percent. So no real change. He noted I have been having some PVC's (premature ventricular contractions) as well. Not really sure that my exercise heart response is actually afib.
My EP came in and my first question was whether when doing the electrophysiology study prior to the burning, if they were able to determine if my AV node (your heart's spark plug) was scarred as much as the rest of my heart from those forty one years of running abuse. He indicated it appeared to fire properly, but force is impossible to measure. Yes, the inside of my heart is scarred up. He said if the AV node was not working properly, he'd have put a pacer in me.
So, he would like me to let my swollen heart heal a bit and start trying more jog walks. So long as my HR stays below 160, try not to get concerned about it. He thinks it will improve with a level of fitness. If it again goes into the 30's in the hour after exercise, than a pacer is probably coming. The truth is that I have an old heart that is wearing out. Early stages of heart failure. How reversible is it? Only God knows, and God don't care about me......
Friday, December 15, 2017
There's gonna be a time
when it's all behind you
There's gonna come a time
when your hands been played....
There's gonna come a time
when no one will remind you
There's gonna come a time
And that times today....
It's been a cold December thus far after an awesome October and November. We had a nice 20 minute blizzard a week ago, followed by sunshine that melted it all within an hour. Otherwise, the drought remains sadly intact.
It has been 16 days post ablation. Some of the bruising has abated, but it will be two or three months before it fully resolves. Groin pain is gone. Today was the first day at the gym where I could resume spinning on the recumbent. Had to wait until my plugs had healed so that the pull wouldn't cause me to bleed out. Afib is still there, and some days walking are perfect, and some days the fib comes partway into the hike. Will be another 4 to 6 weeks before I find out if it resolves enough to try walk/ jogging. If this fails, my options become much more difficult. Another ablation, a mini maze procedure, and/or a pacemaker. Not worried about what will come......I have dealt with this pretty well and will handle whatever I have to. If this had hit me in my 40's, I would have been a psycho. So, as always, the waiting is the hardest part.....
Thursday, December 7, 2017
See those fault lines
Lay down like land mines
It's hard to relax
So they shaved me up, and drove a bunch of cameras, burning catheters, and fluid catheters inside both sides of my groin up into my heart, and proceeded to burn away. A week later, I am all black and blue, and as the hairs starts growing back, itching like a bitch! Pain in my groin is minimal, and slight burning in my chest has resolved. Did approximate hour long hikes yesterday and today, with today's hike being better, with a lower heart rate and no fibbing. Afib still minimally remains, but seems muted. Hope over the next 8 weeks the ablation lines scar and the afib either resolves or gets so minimal, it doesn't effect my exercise activities. If it does, a pacemaker may still be in my future.
Will probably return to the gym a week from today, but there will be many activities I cannot do. The recumbent will pull on my groin too much, so certain weights and walks on a fully inclined treadmill will be what I will be able to do.
And yes, I DO fill up the sock!