Questioning my possible ablation (cold feet)

I have been in NSR for 2 months after my last Electrical Cardio Version. Before that I lasted 1 month; The 1st lasted 18 months.

I have come to the conclusion that Anxiety/fear etc is a big trigger for me. I currently take 3 mg of Ativan a day for Anxiety.

I was found with AFIB in Dec. 2011 at a routine yearly physical. Who knows how long I had been in AFIB before the physical? I expect approx. 10 - 11 months and I base this on when I started noticing my heart rate was above 85 when I checked my blood pressure and the machine would give me a "broken heart" symbol.

Is it to early for me to be Ablated? I was told by a EP in Dec. I was a persistent AFIBBER based on the fact I never come back to NSR without help. He said I was already advanced....


I go to Dr. Natalie on Jan. 21 in Austin. I worry about being Ablated when the statistics show only a 40-60% success rate for persistent Affibers like me.

Maybe I am over thinking this.

That is why you are going to see Natale. For someone with your history, you need his skills to help you.

Forget the typical stats with Natale doing the work Smackman,

While most persistent Afibbers will need one index ablation by a true expert like Dr N plus one more targeted touch up at some point to really get this behind you for the long term, he and his group have been getting increasingly more 'one and done's' even among persistent cases like yours.

Your EP is right, you are more advanced and definitely need a man of Dr N's skill. If you think your anxiety is rough now, just imagine how it will be when you cancel this golden opportunity coming up shortly only to have the beast come roaring back with a vengeance as it almost invariably will in a case like yours. You are liable to kick yourself from Monroe to Tuscaloosa and back!

You will almost certainly be making major inroads in minimizing the amount of AFIB burden after one ablation with Dr N, if not stop it altogether.

He is now over the last couple years addressing all major trigger sources in a first ablation when it's called for to help give the best odds for early success. The longer you procrastinate and go back and forth from one AFIB episode to yet another shock on the table, the more remodeling is taking place making the whole process more difficult at each step of progression.

The fact is Natale is getting a solid 87% for persistent case including those needing only one procedure and those needing a single shorter tune up. The sooner you get the big one behind you the better.

Ask those here who got cold feet ( highly predictable human response) in the weeks and days leading up to the first ablation.

Now that you have made the best possible choice as your ablationist, it's your mind that is our own worst enemy with the thousand and one 'what ifs' and 'oh my God' kind of hand wringing. We all know the drill and hardly anyone here who has been to a top tier expert will tell you that your anxiety and reticence now is anything but unfounded mental noise and 'bargaining' with yourself.

Your last sentence above said it all .... 'Maybe I am over thinking this' ... :-) don't worry we've all been there at one time or another.

I'm sure others here will jump in too and share their similar concerns as the mind starts to chatter as the days get close. Just relax and realize you are one day closer to making a HUGE step forward toward the end of your ablation process and take comfort in knowing that the man you chose will definitely bring you to the end of that process more quickly, surely and safely than anyone else you could possibly start this process out with anywhere!

Shannon



Edited 2 time(s). Last edit at 01/06/2014 06:37PM by Hans Larsen.

My wife would NEVER let me back out; AFIB has changed our life style tremendously! I have got to become Positive that this is meant to be because I believe a higher power led me to this forum to make me aware of Dr. Natalie AND to be made aware Persistent AFIB is difficult to ablate and that the best is only 7 hours from my home.

I guess this 55 year old man just needed a swift kick in the booty to not doubt myself. It is scary but AFIB has changed me tremendously. I am always leary I will "pop" into AFIB with no warning. I drank 2 light beers on New years eve night and had heart palpitations 2 hours later; Scared the Hell out of me.

I just want my life back........

Onward to Austin, Texas Jan. 21

Hi, Smackman,

As Shannon writes above, I doubt there is anyone on this list who's had an ablation that didn't question the decision. There was a point when I thought that I had turned my AF around with diet, stress management and moderate exercise and that it would be an unnecessary risk to have the procedure. That was before it came back, the episodes got longer and longer and finally AF turned into one long episode that lasted five months before I could get an ablation. Ironically I was less symptomatic when my AF became 24/7 because I wasn't worrying any longer about when it might strike again. Problem solved with anxiety in one way. Except it isn't. Dr. Natale told me that one "adapts" to AF, and this certainly happened when I went persistent. But this is not a good sign.

The problem is that with persistent AF the odds of turning it around are almost non-existent in today's world -- at least for the vast majority of us. I waited longer than I should have to see Dr. Natale, and this is also a recurrent theme here. Don't wait, if you've made your mind up, and are now dealing with the perfectly natural fears that come with a procedure that involves your heart. Dr. Danik told me when I saw him in mid-December (ablation with Dr. Natale in August of 2013) that persistent AF when it is longstanding can lead to a point where the heart is remodeled enough that there is no way to make enough lesions to break the electrical patterns of the arrhythmia. This is the truly scary scenario.

I was told before my ablation by others on this list that I was in great hands and that I had made a good decision. I've now been free of AF for the longest period since my first episode in 1994. I've been freed to consider the things in my life that truly matter to me. Travel is easy, and I am much more resilient when faced with stresses that would have constrained my life in the past. Think about these things when you are feeling anxious and fearful and remember that you can get your life back.

Wishing you all the best, and especially on Jan. 21,

Rob

My lifestyle - how I wanted to live and exercise, etc., - was so affected by my 24/7 afib that there was never a doubt in my mind. The docs at Kaiser said. "Just consider this an inconvenience that you have to manage." Crap - they didn't have Afib.

Go to it - Natale is the best.

Glad your wife has your back Smack, ... Hey that rhymes

Listen to what George and Denver say as they have both been there and done that too, just like me and a host of others here.

Be sure and read the whole thread on Hans' retirement from active management of this website and AFIB Report. It's incredibly moving and reassuring to see how many people's lives have literally been transformed by the guidance and support from this website over the years.

These are all folks that know just what you are feeling and have moved past that to much brighter days and recoverying their life.

Count your lucky stars you found this place where people are bold and passionate enough to tell it like it is and not worry about being too politically correct to insist a guy like you do everything possible to put yourself in the best possible hands while also encouraging you to learn about and adopt the many proactive tools like The Strategy and good trigger avoidance that make this site so successful and leads to the kind of genuine outpouring and well deserved gratitude to Hans and Judi for hosting us all and encouraging such high quality discourse on this awful condition.

You made it here, you're on the road to freedom from the beast!

Best Wishes on the 21st!
Shannon



Edited 1 time(s). Last edit at 01/07/2014 10:14PM by Shannon.

Just do it and you won't regret it!
You'll proudly be saying I got a Natale ablation to anybody that will listen!
It's a badge of honor as you're getting ablated arguably by one of the BEST!
Shannon done smacked me upside the head when I found excuses to back out like waiting for FIRM!

McHale

I cancelled my first ablation date with Dr. Natale and at that time I was in NSR much more than I was in AFIB and then two years later when I had the ablation I was two days in AFIB and two days in NSR with afib and aflutter without fail no matter what I did. Who knows how much simpler my ablation would have been if I went through with the ablation the first time. Cold feet is very common but believe me you will not regret it, I have been afib free since July 2013 and I was out yesterday chopping wood and I would have never done that before due to being afraid I would kick off an AFIB episode. I look forward to your post that you have gotten your life back and are doing all the things you use to do, believe me it will feel like you have started life all over again. As the NIKE commercial says "Just Do It".

Thank god for your wife, she sounds like my wife, I was going through with the ablation the second time if she had to drag me there.

Good Luck on the 21st.

KenH

Ablations are best done sooner rather than later. No reason to procrastinate, it can solve the problem.

______________
Lone paroxysmal vagal atrial fibrillation. Age 62, female, no risk factors. Autonomic instability since severe Paxil withdrawal in 2004, including extreme sensitivity to neuro-active drugs, supplements, foods. Monthly tachycardia started 1/11, happened only at night, during sleep, or when waking, bouts of 5-15 hours. Changed to afib about a year ago, same pattern. Frequency increased over last 6 months, apparently with sensitivity to more triggers. Ablation 6/27/13 by Steven Hao.

I appreciate all the positive responses. I am going to get this done Jan.21 at Dr. Natalies office in Austin. I am beginning to get excited because of the great possibility of removing the beast AFIB from my life.

A BIG BIG THANKS to this forum and my new found friends. I do believe I was led here by a higher power for a reason.

Thanks a million! Such encouragement to me and the Wife.

I'll add my two cents worth. I was scheduled to see Dr. Natale eight years ago but was too scared and under-informed at the time. So I cancelled the visit and instead chose to try flecainide over ablation, which did give me six good years in NSR. But a second relapse began last March and has only gotten worse...along with my echo...and thanks to both the inspiration and solid information on the Forum, I'm headed for ablation in Austin on January 24, three days after Smackman sees Dr. N. there. So, yes, no reason to wait, face your fears head on (if you have them) and heed the great information on this site.

I would say if anybody is thinking seriously about an ablation with Natale, they probably better do it before it is too late. You may not be able to go out of network to get Natale or another doctor that you may want, also the hospital.

"Narrowing a network means limiting patient choice of doctors and hospitals in an effort to cut costs. A McKinsey and Co. study says that 38% of Obamacare plans allow patients to choose from only 30% of the 20 largest hospitals in their geographic regions, with another 32% leaving patients 31%-70% of these.

Even Obamacare supporter Timothy Jost, who writes for Health Affairs, concedes Obamacare enrollees will be "unhappy to learn that their doctors are not available and shocked to discover charges from out-of-network.

L

Liz,

I've had my own (non-company) health insurance since 1987. I recently picked a new Obamacare plan that allows me to go out of network. It is about 25% cheaper than my old plan, which had a much higher out of network max (I get no tax credits or subsidies, so am paying full price). One benefit is with the new setup, I can change plans. Before, my afib made that impossible. I could have paid less for a more restrictive plan, but it was worth it to me to pay the extra. You get what you pay for.

George

George:

There have been reports all over the country of people being kicked out of their policies, they have gone to the exchanges and found that their insurance will be much higher with a higher deductible. I guess we will have to see what will happen, hope it works out for you.

The following is taken from INVESTORS BUSINESS DAILY, I pretty much believe in them:

"

Socialized Medicine: More than two-thirds of the public don't think the government can be trusted to run the nation's health care system successfully. ObamaCare is proving these skeptics right.

The public might not agree on much these days, but one thing it overwhelmingly believes is that government is ill-equipped to manage one-sixth of the economy — 67% said so in the January IBD/TIPP poll.

This distrust has only gotten worse as the ObamaCare debacle unfolded, climbing 4 points in one month. Even Democrats — at 44%, up from 34% the month before — are increasingly skeptical.

Little wonder, since every day ObamaCare provides fresh evidence that government can't do the job.

First were the massive technological failures at the health care exchanges, millions of unexpected policy cancellations and sky-high premiums.

Then we saw the administration's frantic efforts to delay and rewrite rules to minimize political fallout.

Now, we read stories about people who thought they'd enrolled in a plan but hadn't, or were told they hadn't, or nobody seems to know for sure.

And doctors, pharmacies and hospitals are now spending countless hours trying to figure out who's covered and for what. Often, even doctors don't know if they're in an ObamaCare plan's network.

The left-wing Huffington Post tells of a cancer patient who had to put off surgery because nobody could tell whether she was covered, even through she'd enrolled via an ObamaCare exchange in December. It took intervention by the head of her state's exchange to sort it out.

Meanwhile, many plans say only 60% of signees have paid their first premium so far. Anthem Blue Cross and Blue Shield reports that as of Jan. 3 just 8% of those who signed up with Connecticut's exchange had done so.

As a result, even though insurers pushed back payment deadlines that they'd already extended once, many of the 2 million who signed up for ObamaCare will end up disenrolled — creating yet another crisis.

On top of all this, we're learning that the industry will likely need a bailout in the near future, since the young aren't signing up as hoped. Humana, for example, announced in its latest 8-K filing it "expects the risk mix of members enrolling through the health insurance exchanges to be more adverse than previously expected."

ObamaCare conveniently provides for such a bailout through the law's "risk corridor" program, which is designed to limit industry losses in the first three years.

Confusion, bureaucracy, delays, crony capitalism, taxpayer bailouts. This is what health care under government control looks like. And this is just the beginning.


Read More At Investor's Business Daily: [news.investors.com]
Follow us: @IBDinvestors on Twitter | InvestorsBusinessDaily on Facebook

I wonder what idiot said this.............
"We have to pass the bill so you can find out what is in it"

McHale

Liz,

Prior to Obamacare, to keep premiums reasonable, one needed to frequently change plans and be looked at by the underwriter. Once one has an illness, like afib, this underwriting is no longer possible. Hence one gets "locked into" the plan they are in. People who can be underwritten leave the plan, so the group in the plan becomes smaller and composed of those who can't be underwritten. This creates a situation where plan prices escalate at a rate significantly faster than health insurance inflation generally. In my case, my afib has cost my insurer very little. The largest expense was when I went to the ER with my initial afib episode, nearly 10 years ago. I had some initial testing after that, but in the subsequent 9 years, my afib cost to my insurer has been $0. In fact, the only cost at all was to set my radius after I broke it in a bicycle wreck.

I have no idea how this will work out generally. All I can say is it is good for me to be able to again switch plans. The company I selected has been in business in my state for 35 years, is a non-profit, and has an A+ financial rating. As a bonus, they include in their PPO network a doc who's philosophy toward avoiding the common chronic illness of aging (diabetes, atherosclerosis, Alzheimers, dementia, high blood pressure & etc.) aligns with mine. If I end up needing an ablation, I'm perfectly prepared to pay out of network fees to go to the likes of Natale or the Bordeaux team.

As to the deductibles being high, that is all I've had for 27 years.

George

George:

The health care industry/ins. needs changes, there is no question about that. The problem is what was passed by one party in the night isn't it, they have made it worse.

Liz

Smackman,

Compared to most of the people who post here, I am a relative newbie. I am not even considering an ablation at this time because my afib (I have an irregular heartbeat 24/7, but not sure what that means) doesn't effect my lifestyle at all. Just going the improved diet and Strategy routine for now.

However, I don't know what's down the road for me and I always follow the posts pre and post ablation and find most of them positive.

I see that your ablation is now in 5 days and I wish you the very best outcome. We will all be awaiting your report as soon as you are able afterward. Good luck!

Louise