2 weeks of NSR !

Last time I had a run this long was Sept 2019 before I went persistent.

Aug 2020 - ablation - several complications - still dealing with some effects

Nov 10 - ECV

Nov 15 - clinical diagnosis of covid in ER - O2 levels in 70s ground glass x-ray and CT, negative test (but typical)

Nov 24 - 2 week run of NSR covid meds did not affect rate or rhythm - due to possible BBB risks and interactions I stopped taking CYP3A4 inhibitors (diltiazem)

Taking just flecainide and eliquis (both BID) and avoiding triggers.

Maintained NSR through all the drugs and stresses so it's looking promising I can be one of those lucky 'one and done'.

It may take a few years before I say "sure glad I had that ablation" and that's long after all complications are hopefully long forgotten.

From what you've said, that clinical diagnosis of Covid was wrong. The real diagnosis was bacterial pneumonia, which would have pretty much all the same signs and symptoms as Covid. Bacterial pneumonia is serious stuff and when accompanied by O2 sats in the 70s it's life-threatening serious stuff. I think you underestimate how sick you were and the effects it was having on you.

NLAMA said: "Maintained NSR through all the drugs and stresses so it's looking promising I can be one of those lucky 'one and done'."

I guess Carey can answer this, but it seems to me that "one and done" doesn't exist. It's "one and done for some undetermined number of years".

I went 13 years after my first ablation, but it came back, and I think I was a lucky one. Have there been any "one and done" ablations?



Edited 1 time(s). Last edit at 11/24/2020 03:57PM by Ken.

It's still unclear to me. I keep learning and researching what might have happened as well as take the opinions of my MD and other health professionals that have seen my records. Additional labs and records keep coming in.

What they told me in the ER was that I had all of the clinical indications of covid and that they often treat people with covid that have repeatedly tested negative for covid. As did I. According to Dr. Paul Marik 20% of people with covid will false test negative for covid. There's more than a few confounders here.

1. I took niclosamide, ambroxol, bromhexmine on Friday, Saturday and Sunday,
2. I used mouthwash about 45 minutes before Friday spit test. Probably below detectable limits based on being in pulmonary stage. (detailed by Marik) [youtu.be]
3. No test in ER (5 days for results)
4. By Tuesdays BioFire panel - all not detected.
5. Primary MD still believes covid based on x-rays and CT.
6, blood cultures taken before er meds showed no growth at 48 hours (indicates that home covid drugs did work)

The ER treatments were covid targeted - lasix, rocephin, solu-medrol and zithromax and mostly appropiate for pulmonary stage and failsafes for bacterial. (too late for viral)

Sent home with lasix, prednisone, albuterol and bromfed. (er drugs)

The reason I relented the idea it was bacterial pneumonia is that the covid specific drugs (#1) didn't seem to give lasting relief but after understanding that by the time I was in the pulmonary stage - and deeply in it (70s) I wasn't dealing with live covid any more but the after effects and debris from covid.

That no growth was seen in blood taken upon admin into ER after 48 hours indicates the covid drugs were effective.

Likely scenario -

caught covid Nov 3rd outdoor dining with 1 friend
9 days later symptoms (should have begun treatment and seen MD after low O2 levels on 8th night)
nights 9,10,11, progressively worse O2 levels
ER on 12th day

z8M8T3E7.jpg large by Marky, on Flickr


mfMLFsmw.jpg large by Mark Dandoy, on Flickr



Edited 2 time(s). Last edit at 11/24/2020 11:50AM by NotLyingAboutMyAfib.

Ken 13 years - I'll take that!

Carey, I found a case study of a guy with many of the same symptoms and number as I had. He's dead.

A 62-year-old man without a significant medical history presented to the emergency department with fevers, malaise, and dyspnea. His temperature was measured at 100.4°F (38°C), and he was found to be hypoxemic with 70% oxygen saturation on room air. Chest radiography showed extensive patchy bilateral mid and lower lung airspace opacities. lymphopenia

[www.ncbi.nlm.nih.gov]

I know this was very serious and that is why I am spending so much time trying to understand what happened.

I was wanting to celebrate 2 weeks of NSR here and the fact that it is robust enough to make it through the trauma of last 2 weeks. It made me happy when ER ran an EKG and told me it looked great.

I hope you just get better so you can enjoy your nsr gift (with prior iatrogenic effects) and nsr is a gift.

Glad to hear your doing better.

No doubt that the stressors from being sick had an affect on your heart.

It's not really useful to try and distinguish between Covid and various flavors of pneumonia based on signs and symptoms because they share most of them in common. Negative Covid test and positive bacterial pneumonia says it was pneumonia. Sure, the bacterial pneumonia could have been secondary to Covid, but Covid that has reached the stages of a 70% SpO2 and ground glass x-rays doesn't resolve with antibiotics, and it doesn't resolve quickly. Weeks, even months is typical. Pneumonia, on the other hand, can respond quickly when appropriate antibiotics are given.

Call it Covid if you wish, but you will never know for sure.

Carey -

Covid tests are unlikely to find the virus for the reasons I've listed. You're missing an understanding of the phases of covid. This video may help. Starts just where you need it to. [youtu.be]

I have no positive tests for anything. Not in the labs done Tuesday 17th, the blood taken in the ER, the covid test on the 13th.

It's clear that if you're waiting to treat covid based on + covid tests you may be waiting a long time. Clinicians, ICU and ER know that. I see it now so strongly, I won't waste time waiting for or taking a test because they unlikely to detect covid once symptomatic.

I was already strongly in the pulmonary stage when I took Friday's test which almost assures a negative test.

I will have ig antibodies test on Dec 1. We'll know then.

I have no dog in the fight covid yes or no - but evidence indicates covid as does 2 clinical diagnosis. ER and my MD.

As I stated the antibiotics likely did no good or treated a secondary infection. It was the steroids that made the difference because those were the right drugs at the right time. Again - all becomes clear in the video.



Edited 1 time(s). Last edit at 11/25/2020 12:11PM by NotLyingAboutMyAfib.

I understand how the tests can be false negatives, but the positive bacterial pneumonia finding isn't a false negative. Without question you had bacterial pneumonia. Was it on top of Covid? Maybe, but your rapid recovery doesn't fit Covid. But like I said, you'll never know.

Quote
Ken
I guess Carey can answer this, but it seems to me that "one and done" doesn't exist. It's "one and done for some undetermined number of years".

I went 13 years after my first ablation, but it came back, and I think I was a lucky one. Have there been any "one and done" ablations?

I'm another Natale, "one and done", ablation after 13 years. At age 83, I suspect I'll be a definite, "two and through," after my next on with Natale in January. I'm in the persistent and mostly asymptomatic stage but don't want to spend the rest of my years even that way.

Natale's NP told me that frequently on 2nd ablations he needs to also ablate the LAA, which is useless sort of like the appendix, which means either the patient stays on NOAC;s for the rest of their life or comes back for a Watchman once the heart has settled down.

Any thoughts?

Gordon

I think one and done's do exist and are actually the majority of all ablations (about 70% overall). But people who get them don't come to forums like this. They go home, get on with their life, and never show up here. The fact is forums like this are heavily weighted by people who've had problematic outcomes. If I were recruiting for a clinical trial for any disease or condition, patient support forums are the last place I would look since they tend to be so negatively biased.

One small correction to Gordon's comment about the LAA. After LAA isolation they'll do a TEE 6 months later to measure the flow velocity in and out of your LAA. If the flow is vigorous enough, you don't need anticoagulants* or a Watchman. About 40% of all patients with isolated LAAs fall into that lucky category.

* Assuming your CHADS-Vasc score supports it.

Two and through also sounds good Gordon!

Why can't the watchman be placed in the 2nd procedure while the LAA is done?

Quote
NotLyingAboutMyAfib
Why can't the watchman be placed in the 2nd procedure while the LAA is done?

It can, and I understand that Natale does combination ablation/Watchman procedures, but I'm not sure what his criteria are. At least in the past he and other EPs generally preferred to wait a year to make sure the ablation was successful before doing the Watchman, but that thinking seems to be changing.

Thanks Carey!

Congratulaitons NLAMAF! Two Weeks Afib free is HEAVEN!! May you make it at least another 13 years!!!or more! I agree! that most people who have one and done ablations never frind this website. They just go on with life. I hope you do too. The fact that you made it through all of that strees, and NSR held means a lot!