My Ablation With Dr Natale (07/20/2018) with current updates

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vanlith
It's only been 11 day's so try not to take anything too seriously....early to mid. sept. is the time to start doing that i say.

I'm not worried. Taking it all in stride. The fact that I converted with only the one dose of Ticosyn, and have stayed there, says something. I think.

Received my KARDIA today. I love gadgets. Took my first reading so I really have no information yet other than my heart rate wa 65bpm and it feels normal. I guess the first reading has to be looked at by a doctor or something like that so I'll wait. Then I can use it at will.

As to my current state I feel really good today except for the Sciatic nerve pain. We will see what happens in a few days after being off of the Ticosyn. Last time I stopped it, it took a few days before I started to feel better. I stopped the Ticosyn monday for my second dose so I wont start onto the Flecanide until Friday as those 2 drugs do not play well together. I upped my dose of Metoprolol to 50mg from 25mg for the next couple days until I get on the Flecanide. And of course I will remain on the Elequis indefinitely,

Like I said I feel really good today and as far as I can tell I have been in NSR since yesterday afternoon. I had some odd heart beats in the morning yesterday but that was it. I also received my ablation report yesterday. Its pretty detailed and informative. My wife, the nurse who I always felt would end up working in an EP or Cath lab, also thought it was good and commented on the details and all the other information within.

Shannon is going to call this weekend and go over it with us as well. So anything that is unclear to us will get sorted out. I'm also glad that my wife will finally get to talk to Shannon. She will have a much better understanding of everything Shannon says that sometimes shoots right over my head.

Started back on the flecainide today. Heart has been quiet since yesterday. Had a brief run of flutter mid afternoon.

Had a busy day today. Took my son to the doctor, had a massage, went to drivers license center, then went to look at a convertible. Smoked some salmon and cod for supper. Life is good.

How long before you get off flec....i am thinking oct. at the latest when your blanking period ends.
Glad you are doing well but only when your off these hideous heart drugs esp. taken daily and still in nsr can you or anyone be really happy and say at least for the time being aaahhh success.

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vanlith
How long before you get off flec....i am thinking oct. at the latest when your blanking period ends..

This would be my guess as well'

My wife was looking at my strips from my Kardia and she said that the recordings I though were possibly affib were runs of PAC's and PVC's. SO that's a bonus.

I had a nice conversation with shannon yesterday. We went over my ablation report and my wife finally got to talk to him as well. This was the first time i have ever spoken to Shannon that remained in NSR the entire time and even afterwards. Milestones.

Just a quick update. Heart has been pretty good only acting up occationally throwing a bunch of PAC's and PVC'S until Tuesday afternoon when I went out of rhythm for a few hours. It came back but then went out again Wednesday morning and has been out ever since. Im not sure exactly what's going on becasue it really does not look like afib or flutter but the rate is high. Dr. Natale contacted me this morning and wants me to have a cardioversion done ASAP. I called my EP in Pittsburgh and they are getting me in tomorrow morning @10am. Dr Voigt continues to impress me with his interest in my health.

I've also been dealing with some severe sciatic nerve pain again and have not been sleeping very well since returing from Austin. I originally thought that it was the ticosyn causing this as when I went off of it the week leading up to my ablation the pain subsided. Then after the ablation and going back on the Ticosyn the pain started creaping back.The pain has been increasing almost daily since my return and reached its crescendo a week ago. Even though I stopped the Ticosyn and went back onto Flecanide. I've only been getting abuot 4 hours of sleep a night which I am sure, coupled with the waves of pain, is contributing to my heart not behaving.

Best wishes for your cardioversion tomorrow. Dr Voigt looks like a great guy, and I'm sure you'll be well taken care of. Hang in there!!!

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jpeters
Best wishes for your cardioversion tomorrow. Dr Voigt looks like a great guy, and I'm sure you'll be well taken care of. Hang in there!!!

Thanks Jpeters. Im hanging tough and staying positive.

Dr. Voigt is exceptional. He actually called and talked to me this afternoon.to discuss my ablation with Dr. Natale as well as tomorrows festivities with me.

As usual the part I am dreading for the morning is the TEE. As I am sure you have read in my previous posts I have only had 1 out of 3 good expereinces at UPMC with a TEE. My newly retired Cardiologist performing the 2 bad ones. So I am interested to see how tomorrow goes.



Edited 1 time(s). Last edit at 08/10/2018 01:41AM by rocketritch.

I had a TEE on July 19th, right before an ablation in San Francisco. So I'm on the table, and we're all waiting for this cardio to arrive so we can get on with it. He arrives about 45 minutes late all stressed out, and first thing he does is try to convince me that I'll never pass it. It's a strange world!



Edited 1 time(s). Last edit at 08/10/2018 01:58AM by jpeters.

Cardioversion went well. Was in flutter.

Met a new cardiologist as well today. My TEE experience was as it should be as well. Uneventful. Didn't even know I had one done.

Dr.Voigt was top notch as usual. He went over my ablation report from Dr Natale with me and we discussed how things went in Austin.

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rocketritch
Cardioversion went well. Was in flutter.

Great!! Welcome back.

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jpeters
Great!! Welcome back.[/quote

Thanks!! I had been having some of runs af PAC’s and PVC’s this week and was wondering if one of those runs may throw me into afib or flutter.

Yesterday was exactly 3 weeks since my ablation so I’m not the least bit concerned. The folks in the EP Lab said not to take it the wrong way, but they didn’t want to see me again. 😁

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rocketritch


Thanks!! I had been having some of runs af PAC’s and PVC’s this week and was wondering if one of those runs may throw me into afib or flutter.

Yesterday was exactly 3 weeks since my ablation so I’m not the least bit concerned. The folks in the EP Lab said not to take it the wrong way, but they didn’t want to see me again. 😁

I got some of those yesterday (connected with my ablation on July 19ty). Thought it might be afib, but after sending in a report was told it was just some normal flutter. I took some diltiazem to bring down the pulse rate, and they scheduled a cardioversion for Monday in case it didn't resolve on it's own. I'm not feeling much in the way of symptoms. It's interesting that if the pulse goes up, systologic pressure goes down to compensate.

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jpeters
I got some of those yesterday (connected with my ablation on July 19ty). Thought it might be afib, but after sending in a report was told it was just some normal flutter. I'm not feeling much in the way of symptoms. It's interesting that if the pulse goes up, systologic pressure goes down to compensate.

I notice them when they happen. I’m very symptomatic. Interestingly I did not notice the flutter as much other than being amped up. My rate was 115. I have Kardia recordings but was unable to personally identify what I was seeing because it didn’t look like flutter or afib to me or my wife the nurse. They even held off at the hospital putting in my IV until my EP verified I actually needed a cardio version.

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rocketritch

They even held off at the hospital putting in my IV until my EP verified I actually needed a cardio version.

Dr. Hongo showed up for mine, taking charge of the entire procedure (getting the pads in the best position, etc). Main advice was not to exacerbate inflammation with too much exercise during the blanking period, and keeping the pulse rate down with diltiazem for the near term. I couldn't be more pleased with my choice EP's.

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jpeters
Main advice was not to exacerbate inflammation with too much exercise during the blanking period, and keeping the pulse rate down with diltiazem for the near term. I couldn't be more pleased with my choice EP's.

I haven't done much of anything since my ablation. My sciatic nerve pain has kept me pretty sedentary since July 20; Taking 50 mg metoprolol and 100 mg Flecanide twice a day and of course the elequis. Also taking K and Mag to keep those levels where they should be. My doctor usually tests me for Magnesium levels when he is running tests but didnt this time.My potassium was 4.3 though on Friday and my mag historically runs around 2. I'm also on a couple things for the sciatic pain as well.My resting heart rate is between 56 and 62 and my BP at the doctors office yesterday was 100/60 so I'm pretty docile on the heart front right now.

Its been a week since my cardioversion and 4 weeks since my ablation with Dr. Natale.

Heart has been in steady rhythm since friday. No PAC's or PVC's that I have noticed. Heart rates have been ranging between 54-62 bpm. My BP was 100/60 the other day at the doctors office. I'm feeling really good, except for the sciatica which is unrealated and at times unbearable.

Everything still good on the heart front. Nice steady beat.

I also finaly got some definitive answeres as to what is going on with my back. I ended back up in the ER on Saturday unable to walk. I had called my PCP on Friday and he fianlly wrote me a script for an MRI but th nuirse was having a heck of a time getting preauthorization. I have good insurance but its based out of Texas. In Texas, even though the insurance provider requires no preauthorization fo an MRI, I would still have to go through a third party aproval. Fortunatly I dont live in Texas, so I dont have to go through that procees. Of course it took the nurse at my Doc's office talking to someone and me talking to two more to find that out. So I scheduled an MRI at the local Hospital to be done on Wednesday.

I woke up Saturday morning with another terrible flareup. I hobbled to the living room and imediately started calling around to see if I could get an MRI done that day. There were several places open but none could fit me in. My wife came home a short while after and we started to talk about my current situation. No MRI until Wenesday. Then another day or two before my Doctor got the results which put me into Friday at best. Then to find a specialist and make an appointment need be. Then who knowas what. The steroids and pain meds are doing nothing for me The pain I have been experiencing is unlike none I have before. It has even surpassed the kidney stone pain I have experienced as well as any bodilly trauma I have expeinced crashing Road bikes on pavement and mountain bikes in rock gardens. So after some prodding my wife and son helped load me up into the truck and we were off to the same ER I was just at the week prior. This is where they did xray's and CTA scanns to rule out any clots in my leg..

I really lucked out in the ER on Saturday though. It was like a ghost town so I went straight to a room. Then I lucked out as the ER doc had back issues as well so he was pretty sympathetic to my current situation. I was unaware of this at first though.After he had asked me some basic questions he said he wanted to tell me something, but not to say anything until he was done. He started off by saying that, like every other doctor, he believes that my back pain is in my head. He then paused for a second and I told him that he was entitled to his opinion. He then proceeded to open his coat to reveal a back brace. He has had a long history of back pain and has had a couple surgeries himself.

So I was lucky and I had my MRI done shortly after speaking to him. So now I know that I have a herniated disc, between L4 & L5. Not the news I wanted to hear but at least I know what is going on and can address the issue. He also contacted one of the pemie back specialist in teh area and he said he would see me this week. All, I have to do is call monday morning to set up an appointment. I am also going to contact a diffeent Chiropractor tomorrow to see if I can get the releif I need that way.

I'm a retired Physiotherapist and Manipulative Therapist. I also studied the Osteopathic,Chiropractic, Maitland and Bowen techniques. Discs have a tough fibrous outer with a jelly like interior. When the outer ring splits the jelly like interior bulges out and presses on a major nerve. I've suffered from it myself in the past and described the pain as molten lead being poured down the inside of my leg. Absolutely excruciating.

I treated many people with this condition with, as far as I can remember, 100% success rate. I found the high velocity techniques of Osteopaths and Chiropractors too severe and always used the gentler mobilizing moves of the Maitland technique. I then gave the patients mobilizing exercises to do twice a day.

Try to find a practitioner who uses these techniques and please think very carefully before resorting to surgery. The fact that your Doctor had a couple of surgeries and still had to wear a back brace tells you all you need to know.

A little tip. If you have to cough or sneeze don't bend your head forward; keep it upright.

It was the er doc that had surgery. It's been my observation that back surgery is no good. I know 5 people that have has surgery and only one had marginal success.

Surgery is an absolute last resort in my mind. I'm going to try to get into a different chiropractor today. I've been reading about a new treatment that has actually helped a guy a know of. And this guy does it. It's a gental decompression type of therapy.

I have to do something. The pain pills don't even touch it. And my walk into work is almost unbearable at this point.



Edited 1 time(s). Last edit at 08/20/2018 06:36AM by rocketritch.

rocketrich - if you can locate a practitioner in your area who is trained Directional Non-Force Technique,
(DNFT^TM) -- try that. It's a form of chiropractic involving 'spinal alignment' that doesn't involve the typical twisting or cracking maneuvers. Very gentle and totally different from what you'd expect from chiropractic.

The results are amazing and offer almost immediate relief from a variety of pain areas including back.
I use it and know many others who also have found relief. You can also consider Prolotherapy - just be sure
you do good research on the qualifications and experience of the practitioner. We have several experts in our area and those having that treatment are very happy with the results for back disc pain and joint pain.

Sorry you are struggling. Severe back pain is horrific.

Jackie

Its been 5 weeks post ablation with Dr Natale. My heart continues to behave since the Cardioversion. I have felt zero PAC's, PVC's, Eptopics or any other anomoly since that day (KOW). Of course the back pain is still there from the herniated disc. I hope to be able to address that this week.

What frustrates me most about the back pain is that it is puting undue stress on me and my heart during this critical time of healing. And for whatever reason, I am to be unable to clearly comunicate that to anyone that could possibly help me. Very frustrating. I actually thought that I was getting somewhere yesterday, but since I am still sitting here in pain it is blaintently obvious that it was just a ruse. So now to wait til Monday to double down on my efforts.

Had a rough day today. What I had been fearing would happen with all the pain actually happened this morning. I went out of rhythm while hobbling into work.

Yes it's that bad. I converted back this evening so all is good for now. Tomorrow starts the third and what I hope is the final round of me getting a nerve block.

Well its been a rough week.

Went back out of rhytm following my last post and have ben their ever since. My sciatic nerve pain continues to be unbearable.I went for my nerve block last Friday and it did relieve the pain somewhat. I also got clareification that I have somehow managed not one but two bulged discs. A right paracentral bulge at the T12-L1 and a far lateral disc herniation right side at the L5-S1. So I'm not sure where this is headed but I have a pretty good idea. Having an EMG done Tuesday to test for nerve damage which will further guide any dicisions.

Needless to say I'm not in the greatest of spirits these days but know that both issues will get sorted out. And I'll be back to normal and put this all behind me.

Talked to Dr Natale's office today. They are going to contact my local EP today to have another cardioversion done. They are wanting me to remain on the flecainide though so we will see.

Current situation.

Second cardiversion since my July ablation is sceduled for next Thursday. I wish they could have gotten me in sooner but that was the best that they could do. So now I wait. I'm a little frustrated but I knew going in that there would be the possibility of another procedure so I'll continue to go with the flow.

On the positive side of things my back pain is allot better these days and will hopfully continue in that direction.

Back in wonderful NSR. Not sure when it happened because I feel like crap.

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mwcf
rocketritch,

Glad you're back in NSR.

If you don't mind me asking, what was Dr Natale's findings and verdict on the procedure he did for you this last July?

During my ablation, and following induced affib my heart was calm. After doing some work on the LAA he moved to the coronary sinus. This is when my affib organized organically starting at the LAA. After working on the coronary sinus he did go back and do some more work on the LAA.

When we spoke the following day we talked about the LAA and the Watchman device. He said that the watchman for me would not be an option right now. First and foremost reason being that there would be a possbility of having to go back and do more work on the LAA. The second would be at my age, insurance would not want to pay to have a watchman inplanted.

That all being said, I am satisfied with the work that Dr. Natale did as well as the work Dr Voigt did back in 2009. In reality I have only had 2 ablations. I discount the one in January as it was basically just a redo of what I had done back in 2009. Had Dr. natale done my second ablation the outcomes could have been totally different. So far as events following my ablation in July the first cardioversion could be in part due to me taking days off of meds to change anti-arrhythmics. And my most recent run of arrhythmia was due to the pain I was enduring with the sciatica.

I am still within the 3 month blanking period at this time, and I did convert back to NSR after being out of rhythm for about 2 weeks. So I do still hold some hope that things will continue to get better knowing that another trip to Austin is a possibility.



Edited 1 time(s). Last edit at 09/18/2018 07:47PM by rocketritch.

Thanks rocketritch.

Fingers crossed that things smooth out after the blanking period for us both!

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mwcf
Thanks rocketritch.

Fingers crossed that things smooth out after the blanking period for us both!

Agreed.

I have been in NSR all this week. The previous two weeks were pure hell. Between being out of rhythm, sciatica and averaging 3-4 hours of sleep a night I felt like a ticking time bomb. Couple that with being off the eleqiuis for the three days leading up to my nerve block while being out of rhythm.

But this has been a new week and I still haven’t lost sight of my goal to rid myself of this issue. I also haven’t lost hope that things will continue to progress in a positive manner as my pain is dissipating and my heart is in rhythm.

Another week of wonderful NSR. Also a short weekend trip to the shore with the family. Life is good.

Nothing new to report. Had a nice conversation with Sharon yesterday afternoon. Took a short trip to the shore over the weekend and committed to purchasing a 65 falcon Futura as well.

Life is good.

Rocketritch - I’m just wondering how you are doing? Hope that your heart is behaving itself? Any PACs or PVCs?

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MissSunshine
Rocketritch - I’m just wondering how you are doing? Hope that your heart is behaving itself? Any PACs or PVCs?

Doing well thanks for asking.

If you read back over my posts or check my blog you'll see I've had quite the time of it.

I had some runs over PAC's and PVC's early on but absolutely nothing for the past 3 week but wonderful NSR.

I'm quickly approaching my 3 month point. It's gone so fast. I have an appointment with my local EP at the end of the month and after that I should be talking with the good folks in Texas to discuss the next steps.

A very busy wek behind me. Drove back to the shore to purchase a 65 Falcon Futura after coming off of night shift. Had a wonderful dinner with the family while we were there at a marina along deep creek Maryland. Made for a long day driving but had good company. Couple that with a 3 day work week.

My heart is still behaving itself and my back continues to improve. Life is very good.

3 month anniversary was Saturday. Dr Natale's office contacted me on Thursday and he wants me to stop the flecanide.

They said I could just stop it but I'm going to do a short taper and be off it by Friday. I'm down from 200 mg/day to 100 mg/day as of today.

There is always a little apprehension when quitting these drugs due to the possibility of things not going as well as you miyhave hoped. Worse case cenario is that my heart does not stay in nsr and I have to make another trip to Austin for another procedure. Which in the grand scheme of things is not a big deal.

If all goes well I will get a 7 day monitor in January and if that goes well will fly to Austin for a TEE to check the function of my LAA.

That is all great news. I hope that another ablation is not in your future. But, as one who has had a second ablation at Texas Cardiac Arrythmia, that is the last thing to worry about. Here’s to NSR for decades to come!

Took my last 25mg of Flecanide yesterday morning. Feels really good to be sitting here in NSR without it. Now the waiting game commences. Hopefully it won't be long and I will be off of the Metoprolol.

So far so good on both the heart and spinal front. Been doing allot of work around the house and garage making room for the new ride.

Had the opporatunity to get out and do a little cycling today between sleeping late getting ready for night shift and physical therapy. Did 6 miles and tried to keep my heart rate below 110 which is practically impossible around hear due to all the hills. The highest my heart rate got during the ride was 124bpm. It's amazing how your fitness deteriorates over the period of 10 months.

Bad wether is looming now so I need to get the indoor trainer and computer set up and start ZWIFTING.

Starting week three without the flecanide. I have been feeling the occational little blip in my chest but nothing major. I'm not convinced at tis point that its not just gas or ocational musce spasm. I take the steps at a pretty brisk pace every day at work, and other than the effects I normally feel from the metoprolol, I feel fine.

I have always been able to feel any little flutter or missed beat but just like back in 2009 my senses seem to be extra sensitive to whats going on an its probably nothing at all. The time lines for both prceedures are pretty similar being that my afib/flutter had become basically persistant.

Rocketritch - so glad that everything is going well! I hear you when you say you can feel every skipped beat. I think we afibbers are hyper sensitive to every beat of our hearts. Carry on and live your best life! I hope to be following you into decades of NSR! I had my second ablation in Austin on June 5th. I had a 20 minute tachycardia episode in mid-September but have been quiet since. Even though it was outside of the blanking period, I hope it was still healing. I wish you all the best! Please keep us posted as to how everything is going and when/if you get off your anticoagulant. There is much to be thankful for this Thanksgiving!

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MissSunshine
Rocketritch - so glad that everything is going well! I hear you when you say you can feel every skipped beat. I think we afibbers are hyper sensitive to every beat of our hearts. Carry on and live your best life! I hope to be following you into decades of NSR! I had my second ablation in Austin on June 5th. I had a 20 minute tachycardia episode in mid-September but have been quiet since. Even though it was outside of the blanking period, I hope it was still healing. I wish you all the best! Please keep us posted as to how everything is going and when/if you get off your anticoagulant. There is much to be thankful for this Thanksgiving!

I have always been symptomatic with my affib. It baffles my mind that there are those that don't even realize they are out of rhythm.

You are right in the fact that there is much to be Thankful for this Thanksgiving. Between my heart and back issues this year, and having had everything improve so drastically, I am indeed thankful. I am also thankful for the wonderful people I have become associated with through this website. I cant put into words the gratitude that I have for Shannon and his assistance helping me get locked into Dr Natale and his staff.

Was finally able to capture a recording of my odd heartbeats this morning. As usual, it happened when I was really not doing much. I had only been out of bed for about 15 min and was packing my lunch. I just happened to have my phone and KARDIA laying there. I captured several recordings. The first looked to be a run of eptopics with a HR of 154 bpm. The second was sinus rhythm with an elevated HR of 88 bpm. The third was another sinus with several PAC's thrown in with a HR of 84. And a fourth recording of sinus rhythm with a HR of 90 bpm. These were all taken within minutes of each other with the first event only lasting about a minute as I went back to pure sinus rhythm within about 15 seconds of the 30 second recording.

I took another recording after I arrived at work. which included a 1/4 mile walk including 4 flights of stairs that would equal around 8 normal flights of stairs in your home. It took me around 4 minutes to get situated before I could take a reading but the reading ws NSR with a HR of 74 BPM.

I emailed everything to my afib nurse and she responded informing me not to worry that everything looked ok and not to worry. i told here I've been in this game far to long to worry. SO its business as usual for now.

Just finished up a nice little walk on the treadmill at work.The heart continues to hum right along and the eptopics seem to have diminished This may be in part due to my steady intake of MG and K.

Going to try and spend a couple hours in the woods in the morning looking for Bambi's dad. If nothing else maybe catch a woods nap as I have one more night shift to do.

Happy New Year. Everything is still going well. An occasional eptopic but nothing really notable. I should be receiving a 24/7 monitor some time this month based on conversations with my afib nurse then a trip to Austin possibly in February for a TEE to see if I can stop the Eliquis.

Still continuing to progress.Getting into the Gym 3X a week and doing a good bit of walking both on the treadmill and around the plant at work. I haven't had a chance to get on the bike though do to weather. The indoor trainer hasn't gotten any use either due to my backlog of household projects that didn't get done this past year.

If we get the snow they are calling for maybe I will get out and do some XC skiing this weekend.

Was contacted by Dr. Natale's office yesterday. They are sending a 7 day monitor for me to wear. If all goes well I should be heading back to Austin for a TEE so that I can hopefully get off of the Elequis.

Talked with Dr Natalea office yesterday concerning the time frame for me remaining on the metoprolol. They said that that decision would be made after the 7 day monitoring period.

I received the Zio Patch today so we will see how things go. The patch is interesting. All monitors I have had in the past were 3 lead type. This just sticks to my chest.

So far as the metoprolol goes I am down to 25mg a day which is what I was originally prescribed anyway. I was only taking more due to being out of rhythm all the time.



Edited 1 time(s). Last edit at 02/01/2019 04:32PM by rocketritch.

Thanks for all the updates it's a real look inside the recovery process. I'm in line for procedure from Dr Natale. Waiting to hear back from his scheduler Amy hoping any day now.