A-Fib for 38 Years: Meds Working, Stays on Coumadin
by Jan Claire, 2010
I wasn’t real happy when my doctor back in the mid-1970s told me I had atrial fibrillation. Number one reason was that I already knew it, because I could feel it being bothersome as it came and went in no relation to anything I was doing.
I also knew it was genetic, because my father, a veterinarian had it and ultimately died of a stroke, since blood thinners weren’t commonly used back in the ’70s.
It wasn’t until about 1984 that my fibrillation episodes began to lengthen, and I engaged a heart doctor in Indianapolis where I lived at the time. He ran me through various medications, none of which had any effect at all on my random bouts of fibrillation. One thing I did know was that the bouts were lengthening. And I was (and am) sure that, as with my dad, they would some day be continuous. That did indeed happen in 1994 when I was 54 years of age.
Tried Several Medications, Settled on Metoprolol
The advantage I had over my dad is that in 1996 when we moved west to Yosemite, California, I found down in Fresno one of the top cardiologists in the state. I got an appointment with Dr. John Telles. We had several meetings, tried several medications, and settled on Metoprolol since it made me the happiest, which made him happy as well.
The thing about Metoprolol is that it masks the effect. I don’t feel the fibrillation, therefore it is not on my mind 24 hours a day. It prevents excessive heart rate, while my heart responds quite well to high-altitude hiking, walking uphill, etc.; i.e., the metoprolol does what it is supposed to do, though I continue to have random beats.
First Ablation in 2005 Ineffective
Dr. Telles did a Pulmonary Vein Isolation (PVI) procedure on me some years ago, July 5,2005, but it altered nothing. However I did enjoy it since he set up the computer monitors so I could be awake and watch the procedure as he carefully built a computer 3D model of my heart, then inserted the “microwave” which would burn tiny spots inside my atrium in the hopes that they might interrupt the random signals causing the problem. Fortunately things were and are isolated within the atrium, and there appear to be no ventricular worries…so far.
As I laid there watching the monitors, I was so fascinated that when he removed everything, I felt a little put out that the movie was so short!
I was wheeled out, put into a nice warm room and allowed to gather myself for a couple hours. Then I opted to stay overnight in a hospital room more to give the entry point (groin) a chance to settle down before the 45 minute drive up the mountains and home.
Second Ablation in 2007: Also Ineffective
The end result was that the first PVI didn’t do much. I went back on my medication. After a couple more years (July 31, 2007) Doctor Telles felt he should make another stab at it, and I fully agreed. I was more than willing to see if some more “tattoos” might do the trick, and his newer version of the software was even more amazing to watch on the monitors.
But both our curiosities were sated by the gut feeling we both had that the second procedure wasn’t going to do the job either. And this second try didn’t change a thing.
Living With A-Fib: Metoprolol Masks My Fibrillation
So, my fibrillation is still with me, and I’m sure Dr. Telles is as frustrated as I. But we both knew from all the knowledge out there that PVI procedures are something of a dice roll. The Metoprolol masks the fibrillation, so I don’t find myself thinking about A-Fib as I go through my days.
Coumadin for Stroke Prevention
As long as I take my blood thinner (Coumadin/Warfarin) like clockwork and exactly the dosage I need for my weight (a 5-milligram pill every day, 7 days a week, and on Wednesday, Saturday and Sunday an extra 1/2 pill totaling 7.5 milligrams on those days), I don’t worry about getting an A-Fib stroke. I haven’t yet asked Dr. Telles about Pradaxa, but I see no sense in going there as I’m 72 now. And at my age there’s a higher risk of bleeding, I hear. Besides, Warfarin’s cheap and effective. I get my Pro-Times monthly, and most of the time they’re right on point.
So, I’m perfectly happy. My A-Fib doesn’t prevent me from doing anything I want to do. The hardest part is remembering to take the handful of various pills each day. But other than that, since I don’t feel it, my fibrillation rarely crosses my mind. I walk up in the mountains, run if necessary, climb trees, work in the yard, all the things I’ve normally done. And, best of all: thanks to Metoprolol my A-Fib isn’t on my mind continually.
Truth be told, I’m far more concerned over which team will win the College World Series.