Jan 2023 Unhappy New Year

 4th January 2023

I ended my last post with a defiant "neither AFib nor HHT is gonna stop me" - until it did!

During my rehab from the nose op I managed to hurt my knee so have now added even more physio to my list - underdeveloped adductors this time...

Then mid December I started getting periods of tachycardia where my heart rate would go up to 100+ beats per minute.  I know this as a precursor to Afib but my arrhythmia nurses said not to panic and see how it went.

How it went was that following a walk on 30 December I sat and had a cup of fruit tea at 11 am.  The tachycardia started and then flipped into full blown atrial fibrillation.  I decided to ignore it even though it was about 120 irregular beats per minute, but felt too ill and so was taken off to the big trauma hospital one hour away.  Not before I had a complete meltdown and was crying and saying, like a brat, "I don't want to go"!

Usually I am seen in about an hour and hooked up to 'telemetry', that is monitoring of the vital signs, to have a cardioversion within a few hours.  On this occasion there were no beds available in A&E and so I was seen by an extremely rude cardiologist who wanted to admit me to the wards.  I was trying to tell him I didn't require that and would be fine after a cardioversion and was happy to wait.  He was rolling his eyes at me and interrupting me and my husband.  He also asked me why I couldn't take Verapamil and when I started to tell him that it had lowered my heart rate dangerously and I was blue-lighted to hospital he just talked over me.  I said to him, "Doctor, you are not listening, you just talked over me" but he still wouldn't listen.  

Anyway, he had the power and I didn't so I was given 5 mg of bisoprolol (betablocker) and told to go back to A&E and await a bed on a ward.  He said it would be safer having me on telemetry on a ward than just sat in A&E and so I had to agree.  He said I would get the cardioversion the next day.

But then I sat there in the waiting room for another three hours in total without any telemetry.  I hadn't eaten or drank for five hours and seeing as the DCCV (cardioversion) would be the next day I ate a single biscuit the staff gave me.  

Ten minutes later I was called into a side room by the anaethetist and told the operating theatre was ready for me!  As she checked when I had last eaten this flipping biscuit suddenly became a major issue - I would need a breathing tube in case I was sick but that would give me a sore throat.  I said I was fine with that as I knew the quicker I was cardioverted the quicker I could feel better.  I was sent back the waiting room for another hour while they consulted about the flaming biscuit!

Next I was told to be "Nil by Mouth" (first time it was mentioned officially - and definitely a bit late!) as they would now do the cardioversion at 10.30 pm once the single biscuit had been digested!  So I sat for many more hours, still without monitoring.

I was then told that there would be no cardioversion after all until the morning but I should remain Nil by Mouth, in case of change of plan.  After 13 hours of waiting (2.30 am) I ate some food and drank a little water as I was on the verge of fainting and I guessed nothing would be done to me that night.  I constantly told the nurses that I was supposed to be on a Heart Rate Monitor and they would apologise and say there were no beds.

An hour later, I began to feel really ill and given the choice between fainting and hitting my head (I'm on anti-coagulents so not advised) I chose to go and sit on the floor.  In reality I was slumped over so the nurses were having to step over me to get back and forth.  I eventually asked for help and it was found my blood pressure was just 66/46 and which point all the action started and the desperate search for a bed was begun.  The nurse said virtually no fluid for 16 hours would do that (on top of the Afib and the betablocker, I suppose) and I would be given IV fluids straight away.

I was bundled into a wheelchair and taken to the ambulance bay in a game called "Hunt a Bed" before being sent to the resus dept where a bed was available "temporarily" as it was reserved for a trauma patient! I remember them doing an ECG but nothing until three hours later when I opened my eyes to find I was in exactly the same position (called in Yoga, the 'corpse' pose) with my shoes still on, four bright strip lights shining on me and no IV though I did have telemetry by now.  I slept another hour and then was visited by my nurse who explained the DCCV was scheduled in the theatre later that day and I should still be nil by mouth.  

At this point I asked for IV fluids which I finally got - so that was virtually no fluids for 18 hours - no wonder I was confused and drowsy.  About 30 minutes later plans were changed again and I was to be cardioverted in the resus dept (which is what normally happens to me) which duly happened a few hours later.  So all in all I was in Afib 23.5 hours.  If I hadn't have eaten that darned biscuit it may have all been dealt with in about six hours.  The quicker my DCCVs are done the quicker I recover.  All because of the lack of communication by the arrogant cardiologist!!

I was discharged an hour later, back in Normal Sinus Rhythm but have not felt at all good in the three days since.  I have cried a lot too as I am so gutted that Dronedarone only worked for five months.  I'm running out of options as three ablations have not worked and now there is just Amiodarone to try....

I'm also pretty sure nobody ever reads this, but I guess it is therapeutic all the same!  Onwards!