I remember the TV commercials from my childhood put out by the American Cancer Society. Their slogan was "Kick The Habit". Now, some 30 years later, I wish more than I can put into words that my mother would have listened to those ads. She was a smoker all the years I can remember but lung cancer got the best of her at a relatively young 75 years old. It took less than 2 months from the time the cancer was detected to take its final toll on my previously strong and healthy mom. If you smoke, I cannot urge you enough to quit. If you can't do it for yourself, do it for the ones you love and the ones who love you.
Of course the "Kick The Habit" slogan refers to cigarettes but I am borrowing the slogan now relating to my heart medications. Under doctors orders, I quit the Flecainide 2 weeks ago and the Cardizem was shelved a few days ago. Since stopping the Flecainide I have noticed a few more skipped beats but still no AF. My resting heart rate is still higher than before my ablation but I expect it will take months to settle down. For the most part my heartbeat has been invisible for the last 12 weeks. I am very thankful for the answered prayers of family and friends.
I continue the daily monitoring with the HeartCard device. The monitoring was scheduled for 3 months so I only have one more week left. After that I am looking forward to being told to discontinue the Coumadin. In the meantime I will continue to enjoy every day of sinus rhythm.
Blessings to you all,
Dave
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10 comments:
Thank you so much for the update. Congratulations--sounds great; it is wonderful to hear good news.
If you are up for questions--what is your resting heart rate now, and what do you expect, or hope, it will eventually become? How does the HeartCard work? Is it much trouble? Do you know about the skipped beats only because of the HeartCard, or can you feel them? What is your energy level now--pretty normal? Any more cautions or comments on Coumadin? Have you needed appointments/tests with your local cardiologist lately, or is this pretty much a matter of just waiting things out on your own? Thank you.
Anne
Good to see someone is still reading our blog. My resting heart rate is usually 70-75 bpm. Before the ablation it was 55-60. I don't notice any difference with the higher rate - the only way I know is what it reads when I take my blood pressure. Speaking of blood pressure, mine has settled out in the 120's over 80's which is pretty good considering I'm off the Cardizem which controls heart rate and blood pressure. I still take a low dose of Lisinopril for blood pressure which is fine with me as long as it is effective.
The HeartCard is about the size of a deck of playing cards and has little metal pads on the four corners. All you do is hold the device to your chest and push a button to start a 30 second recording. It makes a tone that changes with your heartbeat. It can hold 4 recordings before they must be called into a toll-free number. A live person answers the calls and ask if there were any symptoms and where you were when you took the recording. Then they tell you to play the recording back. You place the phone mouthpiece near the top of the device, press another button, and it plays back the tones it recorded. When finished, you pick up the phone again and they will confirm that they received the recording. The HeartCard came with a pre-paid bubble wrap envelope so I can send it back to eCardio at the end of the 3 months.
The skipped beats are something I can feel. I've never been able to record any on the HeartCard because they are so infrequent and cannot be predicted. They call them skipped beats but in actuality they are premature atrial or ventricular contractions (PAC's or PVC's). The premature beat doesn't pump much blood but then the extra long pause before the next normal beat allows the heart to fill with more blood than normal. The result is the following beat feels like a whopper.
PVC's are actually fairly common and some people are more sensitive to them than others. My wife starting having them 12 years ago and it freaked us both out. A trip to the emergency room, a 24-hour holter test, and a visit to the cardiologist told us they were PVC's and that they were nothing to worry about. She still has them but they don't bother her anymore.
I started having skipped beats when I started having AF but in my case they would string together so that every other beat was a PAC/PVC. AF would follow if this went on long enough (15 seconds or so). When I have them now, it is just a single skipped beat and that's it - no AF.
The Coumadin therapy has become less of a hassle but I am ready to be done with it as soon as they let me. My ProTime test results became consistent enough that I only go once a month for testing. My doctor's office uses a finger stick testing method similar to a diabetic checking their blood sugar so the appointments are all of 5 minutes. But I still hope that will all be behind me in the next few weeks.
I haven't had any appointments or tests other than the ProTime tests. Dr. Natale would like me to have a 48-hour holter and an echo-cardiogram done in mid April. I did run into my cardiologist in the hospital last weekend when we were there with my mother-in-law (different issue but her heart checked out fine - praise the Lord). He asked how my ablation went and how I have felt since. I told him great and he just said make sure to call the office and schedule an appointment for the follow up tests that Dr. Natale had requested. My cardiologist was very supportive of my ablation decision and even helped with a letter to get insurance coverage pre-approved. I am confident he would have seen me through any issues but so far there have been none (praise the Lord again).
Dave
Thank you, Dave. I really appreciate the information.
Anne
Thank you for sharing your experience with us novices. I am planning a procedure with Natale this year.
Question-How did they decide which drugs for you to be on after the ablation?
Claudia
We are glad to share anything to help Claudia. I was a novice and had no idea what to expect before the ablation. I had read a lot about the procedure itself but there was a lot more to the whole experience than just the ablation.
They put me in contact with one of the EP nurses several weeks before the procedure to discuss my medications. It sounds like they normally will put you back on the same meds after the ablation that you had been on before, provided they were effective.
In my case there was some question as to how well the Flecainide was working for me before my ablation because I was in the middle of my longest AF episode ever. The nurse mentioned Rhytmol and Tikosyn as other possible choices but switching is not a simple process.
As far as I know, most anti-arrhythmic drugs require or recommend a hospital monitored initiation since they can be pro-arrhythmic in a small number of patients. I understand pro-arrhythmic to mean that the drug can cause other undesirable rhythm problems (tachycardia, etc). Besides the extra hospital stay, you have to let the first drug wash out of your system before starting the new drug.
In the end, Dr. Natale decided to but me back on lower doses of the same Flecainide and Cardizem I had been on before. I had not had too much trouble with either drug except for some headaches and dizziness so that was okay with me.
We wish you all the best with you ablation. Let us know if we can help with any other questions.
Dave
Hello Dave,
I hope you are doing very well and by now you
are all done with the Coumadin therapy.
A couple of weeks ago, on Hans' BB, I asked
you about the insurance coverage of your
procedure. Could you please let me know what
you did to get your insurance cover your
procedure under the travel network option?
My insurance also has something similar, but
I have been told that this only covers illness
and other emergencies that occur when one is
travelling, and it cannot cover a procedure such
as catheter ablation which is considered an
elective treatment. Thanks for being so kind
to help by sharing your experience.
Warm Regards,
Shaun R.
Yes, how did that insurance coverage all work out?
And how did the electrocardiogram go today? Are you done with all the medicines now?
You sounded good last night on the phone. I'm so glad to hear that the ablation appears to have been very successful.
Love you bunches,
your sister Sue
Looks like I'm behind on keeping up with questions - I apologize for that.
I'm no insurance expert but my plan is a PPO (Preferred Provider Organization) and it is less restrictive than a HMO or similar plans. The travel network option did not have any restrictions that I was aware of. It was explained to me that any provider considered in-network with the travel PPO plan would be covered at the normal in-network benefit level.
The biggest insurance obstacle was getting the procedure pre-approved so that I could go to the doctor I wanted. My insurance did have a policy regarding catheter ablation for AF and it stated a medical necessity review was required. I started by asking my cardiologist for a letter recommending an ablation. As it turned out I asked him just before my last cardioversion so he included his recommendation in the report covering that procedure.
My cardiologist referred me to a partner EP that, as it turned out, did not do AF ablations. I was able to get a copy of his office notes that also recommended an ablation. In the meantime he increased my heart meds plus added a beta blocker. Soon after I started experiencing debilitating headaches. A few weeks later the symptoms got so bad I ended up in the ER. The diagnosis was probable side-effects from the heart meds.
I was then able to but together a letter to my insurance that included recommendations from two doctors. I was also able to get copies of the ER report indicating intolerance to the meds that would be required if I did not have an ablation. It seemed like a no-brainer to me but it still took the insurance medical department almost a week to give me the approval.
So far all the hospital and lab charges have been covered in-network. Dr. Natale's fee and the 3-months of event monitoring were considered out-of-network so I had to satisfy a whole separate deductible along with twice the co-insurance. It won't be cheap but so far appears to be money well spent.
I'm not sure if any of this helps Shaun but I certainly hope and pray you can get your insurance to work with you. I know it can be frustrating especially if the insurance company wants to dictate what doctor you can go to. I did consult with another local EP that did do AF ablations but he had not done that many and his success rate was much lower than Dr. Natale. I asked his nurse for a letter for insurance as well but she said they would not write one if I was going to another doctor. She also thought most insurance plans would not allow me to go outside the network. I am thankful this was not the case.
Please let me know how everything works out Shaun. Best wishes.
Dave
Hi there sis. It was good to hear from you too. I should be posting here in the next couple of days with an update on my meds and how the tests have been going. So far everything looks great. We love you guys too.
Dave
Dave,
Thank you so much again for answering my questions and sharing so much helpful information.
Shaun R.
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