Recovery from ablation number FOUR

 

Update January 2025

Well, progress was about the same for the other three ablations to begin with, although I was set back at least a week by all that drama in October (nearly died!  See my previous blog!!).  I was able to do things like Pilates and yoga a bit quicker than before but that may have been due to confidence rather than any physical recovery as such.  My walking was terrible as usual – it was nearly seven weeks before I managed to walk a mile which was several weeks slower than after the others which was really disappointing.  Instead, I used my electric bike a bit although progress was slow to begin with (as usual, sigh).

After about 11 weeks though, my recovery just sped up.  I managed to walk two miles just 12 days after I finally conquered one; three miles came just six days later and four miles a few days after that.  And it felt much more like a normal speed than before.  I was thinking that I would soon be out on my normal bike and even thinking about starting running soon.  I decided that I would wait the full three months before trying to run, however, but I thought that instead I would try some interval walking in the New Year – that is, something like Couch-to-5k but fast walking rather than running i.e. 10 x 1 min brisk walk/1-3 min normal pace.  I was also thinking about venturing out for my first non- electric bike cycle.

 

Then at the dying days of December I went down with a nasty cold/virus/infection thingy – I was only ill for about 4 days but I have now been coughing for 11 days so far which means disrupted sleep.  I was coughing so hard I was vomiting and then that makes my nose bleed due to the HHT.  One night I was up in the night three times for about 45 minutes each trying to stem the flow.  This, in turns, leads to low blood count making me feel even more tired.

 

So, this has set me back a bit too though it is abating a bit now (fingers crossed).  However, from thinking about running and cycling I am now looking at another week or so away from my job as a group exercise instructor instead.  No matter.  I’ll get there in the end.

 

But heart-wise, it has been ok.  I had a run of tachycardia after eating a ginormous Pain au chocolate one day and some odd periods of the same when using (very slowly) the rowing machine.  This seems to signal to me that my Afib is definitely vagally caused.  I’m hoping the rowing machine thing is just a blip but it seems to go well with the episode earlier in the year where a tight bumbag seemed to trigger Afib while running.  I’m thinking of the odd bent-over, crushing the guts position on the rower especially since it was soon after breakfast (and post-Christmas so my gut is bigger than usual ☹).

 

I actually had an in-person appointment with my Electrocardiologist after about 11 weeks and he is “cautiously optimistic” – when pressed he put it as a 7/10.  Mmmmm, I’m much less confident than that so let’s hope I am the one who is wrong!  The EP and I have only ever spoken on the phone, except before each of the last three ablations when he is in his scrubs and I’m in the paper pajamas.  We joked it was nice to see each other properly dressed!!

 

After nagging me to try the fourth ablation because I could not stay on Amiodarone because of its toxic side-effects, he is now saying that if this ablation does not work, he will not do another because there was so little to do (which is probably why I have recovered so much better).  He now says if it has not worked, I will stay on Amiodarone which he doesn’t seem to think is so bad after all!  He also talked up the Pace-and-Ablate procedure and says it will not affect my ability to exercise, but I’m too young for it.

 

Interestingly, although evidence shows that early, aggressive intervention leads to better outcomes in Afib, the downside seems to be that you ‘run out of’ options younger in life.

 

I try not to think about what will happen if (when?) the Amiodarone stops working.  I am considering a Mini-Maze, perhaps even a private Wolf Mini-Maze in Japan!!  But let’s cross that bridge when we come to it!

 

We also talked a lot about what happened to me the day I nearly died.  He asked me to talk him through the whole sequence in my own words and as soon as I said they gave me GTN spray he pulled a face.  As I had already surmised, GTN widens the blood vessels etc in order to allow more oxygen to the heart – this is vitally important if you have angina or a heart attack.  However, widening the vessels means lowering the Blood Pressure (think about having your finger over the end of a hose, where the jet is thinner but goes further/more pressure versus taking that finger away and you get my drift).  In short, he said “their management” of my condition had caused a chain of events which steadily got worse as they gave me more GTN – leading to an almost catastrophic drop in BP as described in my last post. 

 

I am to refuse GTN if it happens again - which I really hope it doesn't as it was very painful prior to the GTN!  We know that my heart (plumbing-wise) is in great condition due to the CT scans and all the other tests they have done, so it is safe for me to do that.  In defence of the poor people in A&E, who have to make split seconds decisions, I was mimicking the symptoms of a heart attack and this is a situation where time is of the essence in preserving as much healthy heart muscle as possible so I can understand why they did act as they did.  And, in the end, no harm done and a rather surreal experience lived through!  And dying is just like falling asleep, very calm, no stress.  Really not that bad from what I saw 😊

 

A bit more on Amiodarone – seems most of the nasty side-effects come not with today’s doses of 1 x 200 or 2 x 200 per day, but back when they were using 2-3 x 400-800 mg!!  Fingers crossed it continues to be benign for me…