Ablation - too much radiation?

I thought I would rename my earlier post, as the subject apparently didn't catch anyone's attention other than Ken..(who was kind enough to reply, but didn't know the answer to this..)

But IS it too much radiation if you also need to get a mammogram around the same time? I am due for my mammo, and also scheduled for my ablation in about 2 weeks. Does anyone know if it's OK to have the 2 things done close together?

Barb

Yes it's okay Barb,

You need the ablation, the radiation is relatively small considering ... The mammogram isn't a huge dose either. But if you feel compelled to postpone one of them, make sure its your mammogram for now.. You can get a thermal imaging breast scan in exchange that can be very effective in highlighting likely suspect spots in the breast, if there are any.

Just don't use some speculative idea about too much radiation to convince you to bail on the ablation you have needed for a long time now. There are risks waking up everyday and while radiation is for sure something to keep track of and minimize when you can, the overall dose from an modern ablation isn't at all likely to cause a cancer unless you have a very high past radiation burden to begin with , and even then there is no guaranteed problem.

Take 300mg a day of R-lipoic Acid in three divided doses as well as 600mg of NAC twice a day and five one gram packets spread across the day of Lipospheric Vitamin C made by LivOn and that you can buy direct from Amazon.com in boxes of 30 or 60 packets (get at least 2x 60 packets to start with) and take that as well as other antioxidants will help a lot in mitigating some of the effects of ionizing radiation from xrays. Start taking this protocol the day before the radiation and continue for two weeks after ablation ..or as long term maintenance if you wish...this will help also with recovery from inflammation as well as general healing.

Take care and best wishes with you upcoming ablation!
Shannon

PS Barb, take the R-Lipoic Acid and NAC with food...that will help prevent any possible mild irritation from the NAC and will insure the R-Lipoic acid won't lower your blood sugar too much which is only vary rarely an issue anyway at that dose of 300mg a day in three divided doses even with an empty stomach.

Shannon

PSS. I just saw your previous post on this issue. It appears you get regular mammograms and this is just a routine normally recommended mammogram by the mammogram industry?? If so, I'd suggest just postponing it for a number of months not so much due to the radiation issue, but mostly to avoid getting squeezed in the chest area right after an ablation which might be a little less comfortable in the few couple weeks post ablation.. Also, in light of the added concern these things bring for you why rush it when you have a busy plate as it is at the moment?

Mammograms are way overdone anyway unless you have an especially high risk of BC to begin with that might warrant extra close monitoring. Thermal imaging scans are a good alternative for just routine checks anyway and there isn't a drop of radiation to consider.

Shannon



Edited 2 time(s). Last edit at 08/20/2013 10:17AM by Shannon.

Sorry Barb - I had intended to post and was side-tracked. I’m offering my personal opinion on your mammogram question..

If you are going to worry or obsess about not having it… then by all means, have it. Stress does a lot of harm and you don’t need that on top of the ablation stress.

However, if you have read about mammograms causing more breast cancer than prevented as the annual practice is being has been ‘re-considered' in the literature some time last year…then, I’d put it off until you can work it in much later on. If you feel you must have it – I’d suggest delaying for a while, at least. Obviously, if you have has a scan that has been suspect in the past, then that’s a totally different issue.

Radiation in any form is cumulative.

Do a Google for (Mercola mammograms). He has published numerous bulletins about the findings and reconsidering of annual mammograms.

Here’s one clip:

The toxic effects of mammogram radiation are finally being acknowledged as a significant factor in the development of breast cancer. Several recent studies have clearly shown that breast cancer screenings may be causing women more harm than good.
A new study published in the British Medical Journal (December 2011) confirmed that breast cancer screening may cause women harm, especially during the early years after they start screening.2 This harm is largely due to surgeries, such as lumpectomies and mastectomies, and other (often unnecessary) interventions. The study highlights losses in quality of life from false positive results and unnecessary treatment.

Fortunately, we're beginning to see the initial stirrings of change, as this latest report from the Institute of Medicine (IOM) shows, which calls into question the role environmental exposure may be playing in the development of breast cancer.3 The IOM committee is absolutely correct in calling for more research into the risks of various environmental exposures over the course of a woman's lifetime. Isn't it ironic that the mammogram—the principle diagnostic test given to women to help detect and prevent breast cancer—is responsible for increasing women's risk for developing it?

Mammogram Radiation is Much More Damaging than a Chest X-Ray
Mammograms use ionizing radiation at a relatively high dose, which can contribute to the mutations that can lead to breast cancer. You can get as much radiation from one mammogram as you would from 1,000 chest X-rays. Mammography also compresses your breasts tightly, which can lead to a dangerous spread of cancerous cells, should they exist. Dr. Samuel Epstein, one of the world's top cancer experts, has stated :[articles.mercola.com]

Jackie

Shannon - thanks for the thermography reminder. It slipped my mind that I had eliminated mammography a number of years ago when thermography became available. It's the only way to go as far as I'm concerned. And it's not just for breast health exams.
Jackie

Ah good! - my two gurus to the rescue

Yes this is a yearly mammo appt. that I usually let slip to about 14 months or so...as I have indeed read about the mammograms potentially causing the problem we are trying to avoid. I also read that they are changing the definition of cancer so that some tumors will not get treated as they are not really cancer. I'm not sure when or if the medical establishment will embrace all of this, but I feel the need to do some kind of testing as I live on Long Island, NY, which has a fairly high rate of breast cancer....I am not aware of thermography..is that done in the same place as a mammogram would be? If it's safer, why don't they use this instead?

Either way, I will take your advice and hold on the mammo for a few months, at least. (and no, I haven't had a history of any problems in this area before, Jackie

Shannon - I am not at all familiar with the supplements recommended and havent' seen them mentioned in other posts. Is this something new? Are they available on Hans Vitamin Shop site? I"m assuming they are OK to take with Xarelto? What is your feeling about Zyflamend?

SO...I have to tell you both that I am getting chicken about the ablation as I have had a very quiet heart for weeks! Maybe even more....it seems when I have to be "on" and am on the go, I get less Afib. (a vagal thing I would imagine..?) But with a calm heart and potential for PVC's and PAC's and so forth after an ablation, i feel like I could be trading calm for ...not so calm. How common is this to happen that things get better when someone has scheduled their ablation? As of right now, i feel like I don't need it.

In case you haven't figured me out yet, I'm a "second guesser'....questioning whether I'm doing the right thing..going back and forth, etc. I hope I'm not driving you as crazy as I'm driving myself...argh.

Barb

>In case you haven't figured me out yet, I'm a "second guesser'....questioning whether I'm doing the right thing..going back >and forth, etc. I hope I'm not driving you as crazy as I'm driving myself...argh.

Yep Barb, JUST DO IT!!!!

afhound99 ~ and I'm guessing you are a "get to the point" kind of guy? LOL. I could probably use someone like you to kick me in the pants when I need it! Like now...

Barb

I believe ablation does provide a very large dose of radiation compared to mammograms and other forms of diagnostic X-rays. I don't have an exact number, but from what I understand, the X-ray machine is on for 30 minutes or more. They do try to minimize it as much as possible and it is less than it used to be (they used to leave it on for the whole procedure but now turn it off when they can). The radiation portion of ablation really scares me. So far I don't seem to need one but I don't know how long my luck will hold out.

But, if I remember right, you said that you're 70 or so? In that case, you might die of something else before the radiation causes cancer, because I've read that radiation-caused cancers can take 20 or more years to form after the radiation event that causes them. So in your case, your quality of life being improved due to ablation might outweigh your radiation exposure.

HI Diane - I have to clear up one thing you said. I'm feeling old enough at 60, haven't reached 70 yet! I'm hopeful that good nutrition, and supplment protection like Shannon mentioned here will help too.

I'm planning to make it to at least 92 And with a calm heart.

How long have you had Afib and how often do you get it?

Barb

Dianne,

The amount of radiation exposure during an ablation done in one of the top centers is about 1.1 milliSievert (mSv). In comparison the radiation exposure associated with a CT scan is 1.0 mSv and that of a mammogram is 0.4 mSv. You can read more about radiation and ablation in Conference Room session 9.

Hans

Barb,

You may be interested in this summary regarding mammography [www.yourhealthbase.com]. I agree that you should consider thermography instead.

Hans

Thanks for this, Hans. I have an appt with my GYN tomorrow for my annual check up. I'l lask for the thermography instead. ~ Barb

Don't be surprise if your doc isn't familiar with thermography Barb... Depends on when they were trained and where.

Most docs gravitate toward the general norm and the industry is still built around expensive mammograms which are far more of a risk than is a good thermography scan which has no risk. If your doc is unfamiliar with thermography which is quite possible, chances are he or she might dismiss it out of hand. But regardless, it is absolutely nuts to get a mammogram like clock work every 12 to 14 months without at least having a confirmed very high established serious familial/genetic risk for BC among the women in your family!! In my book, any doc who would urge me (if I was a woman) to do that with no added risk factors than you have described... well lets just say Id take any other recommendations from them with a big grain of salt.

Over time its the cumulative radiation that will add up and stands a greater likelihood of triggering a cancer of one sort or another than a rather vague and speculative risk
for BC in some women living near Long Island ever would!

There are many well trained MDs in the NYC area who are intimately familiar with thermography and would be glad to test you and follow you from such general preventative scanning.. Then if anything really suspicious shows up they might also then order a confirming mammogram followed by a biopsy, if ever needed.

That is a dramatically safer strategy than just going for annual mammograms in any event ... Geez! what a racket these Docs have going here making annual mammograms sound like a good idea even with no established serious risk factor in all the women they urge this gross over-testing on !!

With in a month or two after you decide to cancel out of your ablation, just realize and accept that it will almost certainly fire up again before long Barb. You've had it far too long with many ups and downs in activity after having tried all the natural means of control to not know how this thing tends to go.. .. It plays with your head if you allow it too. But you will do whatever you decide to do and if you dont go through with it now that is a decision too. And that is how it should be as well. In any event Barb, best of luck to you whatever you do.

I don't think there is really any more I can offer on the matter from here Barb. You have all the info you need now to make your own informed choice and be content with that decision, which ever way you go.

Best, Shannon



Edited 3 time(s). Last edit at 08/22/2013 03:46AM by Shannon.

Thermography has been used in Ohio since 2005 which is when I had my first.

Check here: [www.meditherm.com]

Jackie

With in a month or two after you decide to cancel out of your ablation, just realize and accept that it will almost certainly fire up again before long Barb.

Amen to that.

Hi Barb,

I just noticed you question on the supplements and the last paragraph on one of your replies above that I wanted to respond to for the sake of putting a period to the sentence on your concerns and to help frame the perspective beyond the mind's tendency to rationalize one's situation in the moment and sometimes risk losing sight of the forest for the trees in the way, which can be so easy to do.

First on the supplement issue, you asked the following:

"Shannon - I am not at all familiar with the supplements recommended and havent' seen them mentioned in other posts. Is this something new? Are they available on Hans Vitamin Shop site? I"m assuming they are OK to take with Xarelto? What is your feeling about Zyflamend? "

I don't know of any reason why Zyflamend would be contraindicated with Xeralto Barb, when so many of us used it successfully with Warfarin .. just paying attention to monitoring our INRs and making adjustments accordingly was all that was needed to insure safe use with Warfarin. Same goes for the other supplements. As I said, the LivOn Lypospheric Vitamin C packets can be had in boxes of 30 or 60 from Amazon.com and also from Iherb.com which you can access through the link on this site and contribute to Hans efforts at that link on Hans site. Do not order it directly from this link above or Hans wont get credited I have learned. I put this link here only so you know where to go from Hans Iherb link in order to find the LivOn Lypospheric Vit C.

LivOn Lypospheric Vitamin C

Finally here is the last paragraph in your previous post I wanted to finish up with.

"SO...I have to tell you both that I am getting chicken about the ablation as I have had a very quiet heart for weeks! Maybe even more....it seems when I have to be "on" and am on the go, I get less Afib. (a vagal thing I would imagine..?) But with a calm heart and potential for PVC's and PAC's and so forth after an ablation, i feel like I could be trading calm for ...not so calm. How common is this to happen that things get better when someone has scheduled their ablation? As of right now, i feel like I don't need it.

In case you haven't figured me out yet, I'm a "second guesser'....questioning whether I'm doing the right thing, going back and forth, etc. I hope I'm not driving you as crazy as I'm driving myself...argh. Barb"

Barb, in light of your continuing difficulty in finding the reason and will to do this ablation, I'm reconsidering my recommendation that you do it now as well.

Don't get me wrong here, if I was in your shoes I wouldn't hesitate for a single moment to jump on this golden opportunity to make a huge first step in this 'process' toward long term freedom from this affliction with an ablation by Dr. Natale in your own backyard!

But at some point, you have to see and feel this too and make it your own decision and not feel so vacillating and unsure of yourself. It doesn't matter one bit what any of us think about what you should do, or why. It only matters how you feel about it and if you can find the clarity of purpose, reasoning, and focus to act on this, or not, and that includes the clarity of decision that perhaps you are not ready or willing enough to do this too, which you seem to be trying to justify to yourself at this point.

The issue of 'maybe I might get some runs of PVCs or PACs after an ablation when the last two months its been pretty quiet is not much of an issue with AFIB breakthroughs'. Just remember Barb, PACs/PVCs are almost invariably benign after an ablation and while they can be a little annoying at times, they wont derail your life ot your care for your husband should they occur ... but very many people don't have any significant ectopic experience after an ablation as well. Many of us had very little activity for close to a year and more after a first ablation and that includes not even having longer runs occurring off and on over a few days or weeks at a time of these benign PACs/ PVCs.

Others do have some periods of benign ectopic activity for a bit at some point post ablation ( these are nothing to be concerned about), and a fair number will get some degree of AFIB/ Flutter breakthrough with a certain percentage of those going on to require a touch up ablation by the first six months to one year time frame. That is simply how the process can unfold for different people and its not really a problem when you understand and embrace the fact that this is very much a process to begin with and all of these scenarios are par for the course and its simply not possible to predict precisely which people will be one and done and which will likely require a bit more work to be finished for the most part with this unhandy business. Although it very much is possible to predict that the longer you wait for ablation, once it has become clear that you are going to need one, then the odds continue to grow that more extensive work will likely be required to get the job fully done.

This is all the more reason to take heart in having selected truly one of the very best possible ablationists on the planet to walk step by step with you through whatever your 'process' might require over however long a period it might take to get the job done well and good for the long haul.

Isn't that comforting to know that once you are locked in with a maestro like Dr Natale, he is dedicated to giving you his all in whatever it might take to get you to the promised land!? If it gets done in one shot or takes two ablations, or even much more rarely, three visits to his table over an extra year or a few years to get there, is just part of how life will unfold for you. But almost invariably there will be increasing freedom from AFIB .. particularly after the first touch up should one be necessary and there comes an innate sense that you are truly on the home stretch if not already at the goal.

Your only real job in this business is to make the best choice you can as an ablationist, and then to determine to support his/her work as much as possible by taking as good a care of yourself going forward with all the supplemental, dietary and life style adjuncts that are so thoroughly described on this site.

Since you already made the right choice for your EP, the main question now is do you have it in you to go for it now during what almost invariably is this temporary respite in your AFIB activity? Or, will you be better off waiting until your disease has progressed enough to put enough constant fear of the inevitable into you that it will ultimately force your hand?

If you think you can finesse this thing to decide exactly when its best to re-up with Natale again at some later time when things get more active again, and yet are confident you can time this such that you will not flip into 24/7 persistent AFIB first before Natale becomes available for you again ... and no doubt with a much longer waiting list than you've had now ... then maybe you should roll that dice and take that chance and best of luck to you on winning that very large bet!

I know I thought I could outsmart it too in a similar dance of procrastination, not out of fear of an ablation or what might happen, but out of betting that I could keep the lid on the beast indefinitely with my nutrient and diet campaign alone even though my life circumstances had changed as well and I suddenly found myself living in Amsterdam and no longer is such easy access to Dr Natale etc ... all good rationales for continuing to put it off even when the activity started to pick up again, until suddenly I had crossed that invisible line into highly symptomatic persistent AFIB when that trusty Flecanide that might be helping you a bit now too for the time being, suddenly turned viciously pro-arrhythmic on me almost over night!

Its true, that it is not uncommon for people to sometimes experience a short term reprieve or lessening of symptoms and breakthroughs once their decision for ablation is finally made and a date is set. Perhaps it is from the undeniable stress response interconnection with AFIB that gets a bit of a favorable break with the relaxation from the decision being made and the subconscious knowing that you are now on the road to getting this fixed. It's also common for people to pay closer attention to trigger avoidance and magnesium and potassium supplementation too when they know the date for ablation is approaching in an effort to give the best chance for success you can and that might help keep things more quiet as well.

Whatever the reason(s) ... or maybe its just simple chance ... it certainly is not the case for everyone, nor was it my experience where I was stuck in 24/7 non-stop AFIB/Flutter the last three months before first finding relief on Natale's table. Whatever the case, it hardly matters for the long term outlook as it almost invariably will be back with a vengeance, particularly if the supplemental approach has proven inadequate previously even after a thorough effort to control it that way to begin with.

The bottom line Barb, is that after as long as you have been dealing with this thing, if you truly do feel that you don't need an ablation now, simply because it hasn't acted up since June ( that isn't that long by the way) then my sense is that it will take nothing less than you finally converting to persistent AFIB before you will find sufficient inspiration and motivation to finally follow through with an ablation ... hopefully Dr Natale will still be available whenever that might happen, even though almost certainly it will require at least a 4 month wait, at a minimum, to hook up with him again.

But if after considering all this, and that once you have known that you are going to need an ablation at some point and that you realize the sooner the better in terms of having an easier road for the whole process, if even still your gut feel is that everything considered you are feeling like you have to back into this thing with more trepidation and reluctance, and are still feeling like you really don't need this ablation, then I wouldn't do it now Barb.

But before you make this final decision, take into account too that for people who are chronic 'second guessers', as you put it, the problem is that once they cancel such a previous decision to go for it, it usually doesn't take long at all for that cloud of remorse to descend and for the second round of 'second guessing' that new decision to set in. As such, you just need to decide right now that you can accept that post decision second quessing and determine to not beat yourself up for passing on such an opportunity. I know that this second level of 'second guessing' can be a lot more brutal on the mind than the first stage, sometimes to the point of paralyzing the person around ever making that original decision again to go for whatever it was they passed on,

Just factor that in to your assessment here as well Barb, as you know yourself and your tendencies in this area far better than any of us. But if the balance of your gut feeling is still that you just don't feel ready to do this and feel better off waiting until you know without doubt you must get an ablation, then my sense now is that you should cancel it and go on with your life doing the best you can to keep things quiet and hope for the best.

I just don't see the advantage of feeling like you have to force yourself into this at all and I'm sure Dr N. would agree, and I doubt very much he would want any patient to feel like they have to drag themselves into see him or literally feel forced to come based on other people's opinion!

Seriously Barb, whatever you do, make it your own decision and be comfortable with that. Don't worry one moment what any of us here would think or what we would do. This is all for and about you and none of us can walk in your shoes with all that you have going on as well. We each have made the best decisions we could for our own lives and that is how this all should work in any event.

All our experiences and opinions are just to help give you as much information and nuance as possible so that you can fine tune your own perspective as much as possible. Best wishes which ever choice you make and I'm sure you will let us all know what your decision is and you should know that no one is expecting or demanding that you chose one or the other options. We just want you to make the best choice for yourself as it stands now .. all things considered.

The only suggestion I have Barb, is if and when you should decide to cancel this ablation, please do so in enough time that Natale's office can fill the space with someone on their list who very much is ready and waiting for their ablation to happen, and thus avoid a last minute unwanted surprise for both Dr. Natale and his staff. I'm sure they would appreciate that consideration. Good luck on your deliberations on this issue Barb.

Take care, Shannon



Edited 3 time(s). Last edit at 08/22/2013 08:03PM by Shannon.

My first ablation on June 3rd (Bordeaux) had the following x-ray exposure: 15699 milligrey/cm2 - 134.534 milligrey aire kerma.

The procedure lasted approximately 2 hours.

It's Greek to me, but perhaps Shannon could comment on the exposure.

Barb, it was a difficult decision for me too and I kept putting it off, but all of a sudden my afib ramped up to very frequent (and scary) and there was no doubt it had to be done.

My decision making process would be real easy if the beast returned - I would book an appointment immediately rather than carry on with the risk.

We are so, so, so lucky to live in this era of modern medicine, and to be able to have this operation and have an enormously high probability of success without complications, and to have this afibbers community to support us.

Best of luck to you, Ron

I'm feeling rather embarrassed to have shared my indecision, as I'm feeling pretty foolish right now. This is by far my greatest weakness: decision making. I had trouble even buying a car without extensive research and multiple visits to several car dealers. I'm sure a good therapist would have a field day with me on this, but in the meantime, I am trying to quiet that indecision and trust that I made a good choice already.

I am not backing out of the ablation, Shannon, unless of course something comes up regarding my husband's condition that requires me to do that. I have been so pre-occupied with his illness, doctor vists, researching possible treatments and so forth, that I feel like that's all there IS right now. As I have had very little Afib in awhile (and several months is very good for me), it feels like something that could be put off. But then I realize that Doug's situation is pretty "shaky" and later may be no better either. And I sure dont' want to end up with persistent Afib or have Flecainide turn on me. So I am going to move forward and pray that things go smoothly and I can go back to my famiy with Afib in the rear view mirror, and good health for both Doug and me for many years to come.

Thanks again for the encouragement. ~ Barb

Don't at all feel embarrassed Barb,

Everyone of us knows how tough these decisions can be! And we all know and can appreciate the extra burdens you have to face these days as well with your husbands illness. But that is why the only thing we can do as understanding compatriots in the AFIB war is to clearly spell out the options as we see them too without couching them in kid gloves too much, so that you aren't having to slog through those decisions and the inevitable mental gymnastic that give rise to the many 'what ifs' that we have all asked ourselves at one time or another when going through this phase of the game as well.

When I thought today more about your post near the beginning of this thread, and how we had all discussed these options a number of times before, I got concerned that perhaps you were feeling pressured by all of our recommendations and encouragements to get the ablation, which most all of us feel would be the best thing for you now and in the long run. However, as I noted too, none of us can walk in your shoes either nor know really what is going on for you as well. As such, what I didn't want was firstly for you to possibly cancel the ablation mostly because things might get more active with ectopics afterward and possibly dsturb your temporary respite from AFIB action the last two months.

That shouldn't be a reason to worry or to forgo this opportunity. But if the pressures of everything you are having to go through really were too much at this time for you, then that is a different story.

It felt important after seeing your continued vacillation back and forth over this to make sure you were clear that you owe none of us anything and that this should be your decision alone. You can take bits and pieces from what many of us have shared with you to heart and factor those things into your decision, but none of us would want you to feel strong-armed into doing something that you truly were not comfortable doing at the moment.

Regardless, of how much most of us might feel this is a good opportunity for you to get a major step of this battle behind you. Again, just put aside those passing 'what ifs' about possibly having more activity again after the ablation, You may and you may not, but which ever it is, it will all be moving toward a more stable base for long term quiet to be far more of your experience going forward.

Its always easier to jump on the ablation table when you are in the midst of raging AFIB, but we all know too that the sooner you get this thing taken care of after a long term experience with it as you have had, the easier the process is likely to be over time. The odds are very much with you that this will be a lot easier than your worse fears are telling you now, and I look forward to when you are on the other side of the fence too and at some point able to laugh a bit at what all the fuss was about like so many of us have done too when we finally walked through those doors toward a better present and future,

In the meantime, try to be easy with yourself and recruit as much help from your friends and family to take whatever chores off your shoulders that they can leading up to the ablation and the first few weeks afterward. You'll be back in the saddle soon enough regardless.

And by all means, please understand that you don't have to feel embarrassed, whatsoever, over getting a little cold feet at times. Few here who are now veterans on the other side of the fence ourselves haven't also shared many of the same thoughts before our ablations as well, that is why its so easy for some of us to recognize what is just the obvious 'mind chatter' that is so clever at trying to distract us from the more important issue of focusing on the business at hand and being glad you have such a great team behind you. This wont be nearly as tough as you might imagine ....

Take it easy Barb, and know that we are all rooting for you!
Cheers ... Shannon



Edited 3 time(s). Last edit at 08/23/2013 02:17AM by Shannon.

Shannon - you are truly a blessing to all of us here on this Board.. I thank you for all the encouragement, support, thought and time you have taken to help me - and so many on this board. Whenever I am down or feeling doubtful, you boost me up and give me reasons to feel much better. I don't know what field of work you are in - or have been in - but you sure would make a great ANGEL - (here on planet EARTH!)

I have been having an easier time lately and am wondering if it's because I've been taking calcium out of my multi-vitamin packs and throwing it away for a few weeks at least. AND I have been (mostly) following a low carb diet for a number of months: Medifast....., Because Afib has taken a back seat for awhile, it's also easy to fall back into the vacillating trend. I didn't even consider an ablation in my first 3-4 years as I was always able to self convert - 99% of the time, with exercise. I felt I had some control over it (stopping...not starting). When I started getting it more and more until it became daily - sometimes twice/day, I decided to give in and take Flecainde. That drug was a God send to me...I got my quality of life back. Now on Flec. for almost 5 years, Afib has become very tolerable. Nonetheless, I have had bouts of Afib kick ups (not too recently), and know it's still brewing under all of that Flecainide, I'm sure. As all of the stars are lined up, so to speak, with Dr. Natale in my backyard, YOU, Jackie, Hans and others to support and encourage me, and a need to be in good health so that I can best support my husband in his trials to come,...all seems to point in the direction I am headed.

So I am moving on with the ablation even though I'm not feeling desperate right now. I dont' feel "strong armed" at all. I like to get other opinions and perspectives, but as my family would tell you, I then make up my own mind I know you are all trying to keep me on track for what I said I wanted to do, and to keep me from talking myself out of it. I am trying not to think too much about it and to "Just Do It".

I can't promise my chilly feet wont' show up again, but I'm hoping you will all put up with me anyway

Thank you Shannon - and those who have supported me and/ or others on this great BOARD. ~ Barb

You are welcome Barb,

Its good to hear you plan on going for the ablation now too. I do think both short term and long term that is in your best interest in light of all the AFIB history you have shared with us as well as past efforts to control it.

Don't let a temporary respite distract you either, though I had 24/7 AFIB leading up to my first ablation in 08, prior to my LAA isolation last year I also had a respite from the clockwork like left flutter that occured every 3 weeks to 5 weeks on cue. For two full months prior the the ablation after that last flutter and ECV on June 4 2012, I went all teh way to Aug 6 the ablation day with no activity at all including no noticable ectopics.

And yet during the ablation, Dr Natale was able to immediately trigger that high speed flutter again as soon as he started to stimulate the area where he had had to leave off at the end of my first ablation around my LAA, proving that it was only a matter of time before that open flutter circuit started acting up again had I not gone for the LAA isolation.

It could well be that your reduced calcium intake help quiet thing down. And maybe even some of the focus taken away from AFIB by your other more pressing challenges could have helped a little as well, perhaps.

In any event, you don't really know what, if any silent activity you may have still been having off and on during you overall quieter period as well, unless you have an on-board monitor or pacemaker.

Nevertheless, I know the temptation to procrastinate on this issue and I can only say that the time usually comes to get off the pot and take care of business, so to speak.

Best wishes with your procedure .. you'll be fine! And glad you did it when its over.

Shannon

Thanks Shannon. I was thinking late last night that I had not asked you how YOU were doing. How ARE you doing/feeling after your procedure? I know you had posted just afterwards, but now that it's been a little longer, how are things going?

Barb

Ho Barb,

Im doing fine and it will be three weeks on Tuesday since my Lariat procedure. Can hardly even see the tiny scar on my chest below the solar plexus were the Larait catheter went and the small groin catheter incision is just like any ablation. There were three groin Catheters. Two in the right femoral vein one of which was the Lariat endocardial catheter with the balloon and magnetic wire tip and the other was an ICE camera to better visualize the LAA mouth from the right atrium to go along with the TEE imaging from the esophagus and short term use of fluoroscopy during the procedure.The third catheter requiring a second small right groin incision was for a arterial blood pressure monitor that was placed in the right femoral artery.

In any event, I had some periodic tiredness during the day for the first 10 days to two weeks but that has pretty much dissipated now. Very little discomfort ... just had a mild to moderate sensation in my upper left side of chest where the LAA is, or was, that for about a week felt a little like the kind of narrow focal point of pain like a sore throat kind of razor blade feeling except rather than being on one side of the back of your throat, it was further down and to the left of the esophagus .. again just where the LAA is. I would only feel it when taking a bit swallow or deep breath or picking up something a little heavy with my left arm. and it was just a transient twinge and not much more.

It was nothing I would have even taken a Motrin for on its own so no big deal at all. There has been a funny kind of occasional 'presence' in that same region of the left upper chest like a mild squeeze sensation from time to time and all of it is likely just symptoms from the necrosis of the LAA starting.

But overall this has been far easier and no big deal than I expected! I'm very pleased so far with everything and can hardly wait until Sept 23 to get the confirming TEE in San Fran and the next day on the 24th when Dr Natale will give me what I trust will be the good news that I can toss the Coumadin for good! .. keeping fingers crossed but I feel pretty confident its more or less a done deal already.

Bottomline, once that good news is confirmed and based on my experience going through the procedure and this first three weeks afterwards, I would definitely say this is an incredibly small price to pay for freedom from blood thinners AND a total elimination of embolic stroke risk coming from the LAA!

Thanks for asking and have a relaxing rest of your Sunday Barb.
Cheers Shannon

Ahh, that's good to hear, Shannon. As you know so much about all of this, you seem to handle the "blips" and 'bumps" better than alot of us might. Am looking forward to hearing your good news from Dr. Natale also. To be off of blood thinners and know that you have eliminated a big threat to your health will be liberating, for sure!

Barb

Barb, I don't think there is an easy answer to your question in general because literature talks about average exposure. For mammography, the range is relatively narrow and predictable. It is less so for AF ablation because a fast procedure may only last 45 minutes (ablation time only - not including periprocedure things like set up, wait, post ablation tests, etc..) and a complex one may take 4-5 hours of ablation time. Since Dr. N is doing your ablation, the controllable portion of x-ray exposure is going to as low as you are going get. Exposure depends on the complexity of the procedure, length of the procedure and equipment used. For example ICE does a pretty good job of telling catheter location without xray and I am sure Dr. N uses that often. I think ICE does a better job showing soft tissue boundaries compare to xray anyway. Everybody has 3d mapping/navigation systems nowadays and that also helps with catheter location. You can't do better than Dr. N as far as success rate and complication risks.

My father died of cancer 18 years ago. I am sure he got the cancer from angiograms that he had on his path to getting CABG. The CABG worked great for him. He complained of minor chest pains around his heart area a few years post CABG and thought for the longest time that the arteries were clogging up again. Angiography was still being perfected and proctored when he did it. Equipment is much better now with lower xray dose.

Researcher - what is CABG? You raise a good point about the ablation - it surely does depend on how long it takes - and it should take less time with an experienced EP. Hoping of course mine doesn't take real long....

~ Barb

Hi Barb

CABG means Coronary Artery Bypass Graft surgery. Most often just referred to as Heart or Coronary Bypass surgery in much of the lay press.

And yes researcher did bring up a very good point about radiation dosing and duration of procedure as well as the fact that the most experienced operators not only do their work in less time relative to the difficulty of the work needed on a given patient, but are often also more skilled at minimizing radiation usage for the most part.

Shannon