Natale Ablation Thursday Flew Sunday Pain While Swallowing Monday

Hello All
Thank you to Jackie, McHale and Shannon for all their support. Wednesday flew from NYC to Austin for Thursday 7am Ablation. I will say we loved everyone we met and I am sure that the level of nurses and OR staff were far superior to what we would have gotten in NYC. The docs were very comparable Vivek Reddy in NY and Natale in Austin but several thing tipped me into flying for the procedure.
Anyhow... felt Super Great even friday 1 day after procedure. Yeah tired and some ache in mid chest but nothing motrin could not handle. Saturday at hotel was fine but tired. Couldn't walk more than a few blocks. Austin is great though and they have cabs.
However upon our flight home last night eating relatively soft food and drinking tea i started to have pain at bottom of sternum upon swallowing. Today day 4 i have pain even swallowing my own saliva. I can feel it the last 2 inches before sternum. It is not at all sore in my throat. Obviously nervous as all over internet says Esophogeal Ulcer. Anyone have similar pain post surgery? If so how long did it last? Help Yikes?
thanks all

Hi Susan,
Wow you were determined to get this FIXED and you got in quick no less!
Last time we talked a few weeks ago you were trying to make up your mind who to go to.......... I guess what I said doing less is in nobody's best interest........less is not more so Natale was your man!

As for the pain, I was spitting up some blood for about 10 days and had some pain for maybe a 2-3 weeks when swallowing. It's irritation from intubation tube I'm assuming!

Get well and rest up!

Best,

McHale

Hi Susan,

As I noted in my text last night, you were given Carafate and PPI upon report of the minor pain on swallowing which is standard operating procedure. This report is fairly common in the few days post-op and can be from either the intubation tube irritation as McHale suggests and possibly very mild esophageal irritation from a thorough posterior wall isolation, a passing bit or pericarditis from all the burning and healing going on or a little bit of all of the above. Do not worry about it, Just as you were concerned about the minor chest pain the first day or two and then it went away as I noted it would on Friday when we spoke on the phone just after you had checked out of St Davids after rather quick very uneventful and straightforward PVAI by Dr Natale, . Just take your Carafate which is quite soothing while the natural healing takes place and you should be just fine.

I would only be a bit concerned if a more significant pain with a fever started to appear for the first time after a longer period of time after the ablation than around 4 days post ablation as in this case. On the other hand, since Natale hasn't ever had an esophageal fistula in all the many thousands of AFIB ablations he has done and the symptoms you are having are very common indeed as part of the aftermath and healing process of what turns out to be a very successful ablation process, I seriously doubt you are his first such case and what you have described isn't even close to that in any event. As such, there is really no need at all for worry or concern.

You did, after all, have an index PVAI plus SVC isolation procedure which is a significant invasive procedure though to your good fortune done by one of the very, if not THE very best ablationist anywhere. Allow the Carafate and PPI medication and a few more days time to work and pass, respectively in peace and contentment with a job well done and not worry yourself too much over such a predictable passing experience.

It could also just be a manifestation of a garden variety pericarditis too which often feels irritable when swallowing in the early days after an ablation and it too is part of the inflammation/healing process as is the discomfort on taking a deep breath that has largely gone away now. Even as a minor pericarditis from the burning done during the ablation is healing it may well shift in its manifestation to feeling like an esophageal irritation as well considering the close proximity of the LA to the esophagus to begin with. with the LA directly over the esophagus, discomfort originating from a pericarditis in or around the LA can easily be referred to what feels like the esophagus during swallowing.

And its possible a bit of minor swelling is in the lower esophagus for a few days from the solid job of isolation of the posterior wall as noted above, that later functional part of the ablation you really want to have been done well. So either way, a little time and the meds and instructions you have been given will do the trick and all that will fade away in due time as you continue to heal and recover.

You said it yourself on Saturday, that you have been pleasantly surprised that while there has been some discomfort it has been a good deal less than you imagined before hand. I trust too your flight back to the big city from Austin was not too big a deal as well? Such finding are often typical, especially with such an expert ablationist in your corner.

Take care, congrats on getting this done and being on the other side of the fence, and the best advice is to avoid excess concern when so far its all coming up roses in your case. Best wishes and ...

Cheers!
Shannon



Edited 1 time(s). Last edit at 05/20/2014 09:13AM by Shannon.

Shannon
Thanks for the time knowledge and support that you bring to the table . I am sure i speak for many of the others when i say I am forever grateful. I must say I don't remember being concerned about my mild chest pain at all as i knew to expect it, it went away fairly quickly and i felt better than expected sooner as i said. From everything i can gather from reading research papers and from what Natlae's own nurse said...new pain day 4-5 is likely a "scorched esophagus". Praying it is just scorched and not a ulcer but will say it is not minor pain although thankfully not constant. It does however occur almost every time i swallow saliva. So even if one is trying not to focus on it, it becomes apparent often. As you can imagine being back home with 3 children, i am tons distracted yet i am still in pain. Obviously a bit worried!. And.... While i too hold Natale in the highest regard.... Lets all remember he too is human and even he has a 1% complication rate so in 500 per year that is 5. Apparently, having to take 2 more drugs for 14 days post surgery does mean a complication as such. Pain is not in upper throat or at that hollow in neck. Nurse thought less likely from intubation and most likely a burn.

McHale I wouldn't say you spitting up blood for 10 day was so much fun either. But thank you for sharing that.

Would still love to hear from anyone who had pain in sternum last 2 inches upon swallowing especially saliva. Cool water does not hurt as much. Wondering when it will go away and i will feel better.

thanks all
praying for a quick recovery

Hi Susan,

My point above was not to minimize the discomfort you feel when shallowing at the moment, but only to reassure you that in all likelihood it is the typical post ablation esophageal irritation that is often part and parcel or a thorough ablation.

Many here have experienced that to one degree or another and as noted it can have several etiologies or combinations of factors contributing toward it, almost all of which all fall, in my book, under the heading of more or less expected and transitory sequela after having a branding iron tattooing the inside of your heart for just shy of an hour.

The one you really have to worry about though along that line of symptoms is the esophageal fistula and I want to reiterate again that your described symptoms and timing, as concerning and uncomfortable as understandably it might feel right now, will almost invariably turn out to be the passing variety and nothing close to a real or what I would call major complication even close to a fistula. In all likelihood it is very similar in scope and scale to the minor chest pain on deep breathing we discussed Saturday when you mentioned it and that I reassured you would also pass in a few days as thankfully it apparently already has from your other text last night.

Have you started the Carafate and PPI yet? I know from my own experience, and that of others, the Carafate will tend to help sooth that feeling pretty quickly and gradually it will fade into a distant memory. Just give it some time and patience and try not to worry too awfully much in the meantime.

Regarding the stats issue, in my experience and from all reports that I have heard, the vast majority of the roughly 1% rate of reported 'complications' for Dr Natale fall within these similar expected range of reports and events after a significant invasive cardiovascular procedure of this nature, such a mild to moderate transitory pericarditis with discomfort on deep breaths, mild to moderate transitory esophageal discomfort such as you are having, groin hematoma from the insertion site, occasional temporary digestive motility delay, mild to moderate transitory fever. These all fall into the range of the kind of events under the 'you can't expect to have an utterly discomfort free ablation and still get the job well done'. kind of 'complications', as opposed to the more serious and fortunately extremely rare significant complication such as PV stenosis, Phrenic nerve palsy, stroke, MI, tamponade, and the dreaded esophageal fistula etc.

Though for sure Dr Natale, as even the most elite EPs, all have some degree of real complications from time to time, however vanishing few compared to the average ablationists one might run across.

Some patients get the Carafate and PPI right away post ablation. In your case, and for similar run of the mill early paroxysmal ablations as yours, they might have felt that given your textbook case of PVAI plus SVC isolation they would only issue those meds if, and when, you reported any irritation and discomfort like you have, rather than prophylactically as often is done with more extensive persistent cases that typically require more burn time on the table. No doubt its a judgment call on a case by case basis.

Nevertheless Susan, my strong hunch backed by years of experience at this game is that in the months ahead, you too will joint the chorus of folks here sharing with others from time to time how much easier this all was, even with a few relatively minor bumps in the road, than what we all feared and projected before hand.

I certainly hope so and am counting on it :-)! Just take it easy the next week as much as that is possible with 3 kids, which I imagine is not at all so easy as it is to say, dont rush into things and keep the exercise on the minimal side such as mostly nice long walks and perhaps some mild toning and yoga or pilates type of stuff the next two weeks and things should start to shape up rather nicely.

Also, remember in advance too that any blanking period runs of flippies and/or ectopics that might possibly occur do not inherently signify the need for a touch up during these first couple of months and most often are passing issue of remnant healing period transitory activity.

Having just happened to be there in Austin still when your ablation was underway last week, I know that Dr Natale was happy with the way your ablation went and best wishes on being on the other side of the fence having already made the single biggest step in your mercifully brief AFIB journey toward a life of freedom from the beast at this point!

Take care, Shannon



Edited 1 time(s). Last edit at 05/20/2014 10:07AM by Shannon.

Hi,

out of interest: What is PVAI (what is the 'A'?) and what is SVC? I´m not so familiar with the english medical abbreviations?

And another question: What symptoms are to be expected after a straightforward PVI? Soreness and/or pain as described by Susan?

Thanks for your help

Dirk

P.S. I´m due for an ablation with Dr Lewalter (Munich) next Wednesday.



Edited 1 time(s). Last edit at 05/20/2014 10:38AM by Dirk.

Hi Dirk, A stands for antrum and SVC stands for superior vena cava. I am pretty sure your Munich EP follows similar guidelines to avoid PV stenosis. SVC ablation is standard.

Hi Susan, Degree of pain is subjective. In general i can tolerate alot of pain but only if I know it is to be expected and that it will resolve on schedule. After my first ablation in NY with DR Natale I had uncomfortable pericarditis and esophageal pain and I too thought that it would be just my luck to be Dr Natal;e's first fistular. On the night following my ablation I had substantial pain from pericarditis. A resident came is for a routine check on my condition. He tried to reassure me that the pain was to be expected. Since I sensed that he didn't know enough about ablations to know what was to be expected I asked to have his supervisor come see me. He did and the Chief Resident didn't know much more than the resident about ablations so I asked him to consult with an EP. Of course he didn't want to but I insisted. The pericarditis had appeared suddenly and I felt like there was a good chance something was seriously wrong. The chief resident consulted with an EP who reported that what I experienced was to be expected and it would slowly resolve over several days. After this reassurance and Shannon's comforting reassurance, i felt somewhat better and with some effort put it out of my mind and the pericarditis and the esopageal discomfort was easier to tolerate. The esopageal discomfort took about a month or so to resolve. When you believe what you are experiencing is what most of us have experienced you will not worry as much. Good luck! Dennis

In my readings on this site, most of the women that have had ablations do not fare so well, they appear to have more problems and a longer period of getting better. I wouldn't go for an ablation unless I was getting AF every other day or so.

I, however, wish Susan all the best and a speedy recovery.

Liz

"What symptoms are to be expected after a straightforward PVI? "

Dirk, I can tell you about my own experience after a standard PVI about 18mths ago. I have been AF free since the ablation. What I did experience, which seems pretty typical, is some extra (or more noticed) PACs or some instability for want of a more precise description while in the 'blanking period' which is the first 3 months after ablation. Heart rate typically also rises and settles down over time.

It makes sense the heart would take a while to gain a new equilibrium after being scarred. I had a few scary episodes after ablation but this forum (along with my EP) helped reassure me I was seeing nothing unusual. It took 7-8 or so months in my case for my heart to feel solid in terms of steady NSR and heart rate.

I had Cather Ablation with Dr. Natale on Feb. 27,2014. I had a "sore" hurting esophagus. I had the Doctor to write me a prescription for the Carafate which I filled before I left Austin. I used it around 3 days after my discharge.

I still had some discomfort but it was tolerable.

Follow up to Liz post regarding females having a harder time with AF treatment. Below is link to article in current issue of JAfib regarding gender differences in ablation outcomes and complications. Registration required and it is free.

[www.jafib.com]

Hello everyone,

I'm scheduled to see Dr. Natale for consultation in June.

BUT, I have to admit, I'm somewhat freaking out from reading about all these pains, PAC's, PVC's, Afib episodes, coughing up blood, etc. that you folks have to endure up to 8 months or more after ablation ! Wow!

I'm just thinking and confused. Is it worth it for my case? My mind is starting to play tricks on me. Should I try to control my condition and delay the ablation and hope for better technology and more advanced procedure in a few years?

I just don't know. I'm still going to see Dr. Natale for consultation anyway for now.

Duke



Edited 3 time(s). Last edit at 05/21/2014 01:48PM by Shannon.

Thanks All - comments and 2 more questions

I think Dennis hit it on the head. If someone had just come out and shared this is what can happen. Or.... this is what you have and we see or hear it all the time...take the Carafat and prilosec and you should be fine in a few days-weeks, I would have been fine. Instead I felt really good by day 3 and then day 4 was blindsided by a different pain on swallowing. Then when I called day 4 and said i had pain at bottom of my sternum one nurse called it a scorching other said she never heard of it... i was concerned. As i said the research i was reading about pain on swallowing in sternum post a fib ablation didn't help. It was NIH.gov research papers but scary.
BUT... Thanks to this site and Shannon.... Seems you all have had a fair bit of this and it takes a while to go away. This alone makes me feel better and I too can hope I am not going to be Dr. Natale first fistula patient.
TODAY...On day 2 of Carafat and prilosec and can say for sure it is not getting worse which it did from Sunday night thru this am. It is stable to slightly better. Praying it will continue that way.
So questions
Did anyone eat differently during that period?
How long does it last?
When did you begin exercise besides gentle walking?

TO LIz- I would never have done this if not necessary. I was at the point where i had no life and couldn't perform my daily life. I was having Afib every 2 to 10 days lasting from 6-16 hours. Unable to work in my elected town government job, drive my kids, help with homework, cook or food shop, exercise, travel and just plain live. Even getting into bed once my a fib started my HR was 120-140. If i walked around during episode it was 140-168 and i was out of breath and feeling like i would pass out. One drug gave me another arrhythmia VT or SVT and i then tried managed with a great functional medicine doctor, osteopath in nyc, supplements and great anti-inflammatory diet and low HR impact walks. This all ssince last October. Started in July with a vengeance, 10 months ago. BUT ...This year when i had 3 episodes every other day starting on flight to the warm vacation which forced our family to abort the trip early I said enough is enough. I have no life and can't live like this, my husband heartily agreed as it effected his life as well. So trust me. Do everything first. And honestly before a fib i was healthy other than 2 glasses of wine every night I exercised a lot running or spinning and we ate really well. God just had other plans.
Thanks for the well wishes
Answers to questions above appreciated

Susan,

As a non ablatee, I can't advise on when to start doing more exercise. I would suggest you look hard at defining yourself as a runner and a spinner. Many of us lone afibbers got here via chronic fitness. I know, that was/is me. It took a while for me to understand that traing for and competing in endurance events was not heart healthy afib wise. Today, I'm certainly no couch potato, but I do consider that I'm spending my limited store of health resources when I indulge in these activities rather than considering I'm adding to that store of health. I have redesigned how and how much I train dramatically.

Good luck!

George

Sorry I cannot speak from ablation experience but, in general, when it comes to medicine and invasive treatment especially, the keywords MUST be "caution and knowledge" or "better safe than sorry".

Therefore, on a personal basis, my personal policy is simply that if I am not expecting a certain reaction or symptom, pain included, I will want an explanation FROM SOMEONE WHO KNOWS WHAT THEY ARE TALKING ABOUT. I am not, for instance, going to ask a podiatrist about heart ablation issues.

Once explained I know that I can rest comfortably, pain or not, knowing that what I am experiencing is normal.

For me, anyway, it is really as simple as that. NEVER EVER EVER be afraid to ask questions or demand (diplomatically) a complete explanation of what has gone on and what to expect, etc. A 'professional' has a duty to their client/patient in this regard and although they may be short on time, the explanation and investigation (if necessary) is obligatory and a fiduciary duty.

Having said that, I am wishing you well for a speedy and total recovery in short order. I will find out in a few weeks whether or not I am on the "good to go" list for an ablation. Dr. Verma was not quite anxious to do a CA on me due to an enlarged left atrium at first (60mm) and then later on due to my 100% resolution on TIKOSYN (since December 2011) but with a shrinking left atrium (down to 54mm one year ago).

As a matter of interest to those that are waffling about with aFib..... my first cardiologist waffled about with me for over one year (!) due to HIS vacation schedules, timetables, INR nonsense, etc., permitting my LA to enlarge from 49 to 60 mm during that time as I was essentially in permanent aFib. If I had been referred to Dr. Verma immediately I would likely be finished with my ablation, any touchup(s) and be in NSR at this time instead of fighting the side-effects of TIKOSYN and waiting for the green light on an ablation.

Bottom line? You ARE entitled to investigation of anything that is non-normal and a full explanation thereof, by YOUR EP and not a foot doctor that happens to be on-call that day. And, ablation surgery being no minor procedure, I would certainly not hesitate to request a quick nose-to-nose to have the question investigated and answered. ANY good EP would be more than pleased to put your mind at east (and theirs) after a CA.

Regards,

Murray L

--------------------------------------------------------------------------
Tikosyn uptake Dec 2011 500ug b.i.d. NSR since!
Herein lies opinion, not professional advice, which all are well advised to seek.

Susan,

Had an ablation with Natale in Austin three years ago March. He advised me to not begin my exercise program for 2-3 weeks. I have to admit that I started again with quite a bit of anxiety as atrial fibriillation had began to occur during my workouts!! No problems when then or since.

Other than a sore throat from the "trach tube" I had zero after-affects from the procedure and basically was back to normal very quickly. My procedure was on a Thursday, came home on Friday and was back in my office on Monday.

When I was in pre-op for my ablation the anesthesiologist came in to explain what was going to happen......he stated that I could experience some discomfort in my chest for a few days afterwards. He went to say that the best way to describe the discomfort is that it would feel like hearburn. Then, he paused for a few seconds and then said...."I guess that is because they are going to burn your heart"!!!!!!

Steve
Spring, Tx.

Hi Duke,
Just need to suggest not to go too far in reading too much into these experiences ...time for a reality check, you are getting the wrong and vastly overblown impression here.

To forgo an expert ablation when you are staring to become more progressive, as in your case, soley based on the reality of the actual relatively minor and transitory discomfort
of the kind being shared above, and that has been discussed here numerous times over the years, would be the height of over-reacting folly in my view.

Not one of these people above sharing their experience of passing esophagus discomfort or pain that I'm aware of will advise you now to postpone your ablation as a result until some magical future when the whole thing can be done by osmosis with even the pain of a needle stick for the IV or the discomfort of ripping the little EKG stickers off you our chest or arm hair is avoided..and in which only modest sedation was used but no general anesthesia with accompanying intubation as well.

This IS cardiac surgery for to be sure, although FAR less invasive and less painful in the vast majority of cases than the majority of other cardiac procedures as it is, with generally much quicker recoveries as well. Some are sounding like they expected there to be next to no discomfort at all throughout the entire experience which is entirely unrealistic.

Let's keep this in perspective.. Any kind of procedure like this is daunting enough for the mind to wrap itself around, especially for those of us prone to 'white-knuckling' such things in life, without adding unfounded fear where none is warranted.

The only folks getting an ablation who can expect to not feel a single thing in the area of the esophagus are those in whom their EP avoided ablation of the posterior wall entirely or who was so reticent in trying to successfully and safely address this important area that nothing very effective gets accomplished usually leading to multiple repeat ablations if the person keeps going back to the same or similar-minded EP who avoids such a key area or arrhythmogenesis in their case rather than learning how to do this aspect of the procedure with expertise and safety.

The important thing is finding an expert EP with the skill and knowledge to get the job done with consistently great results with tolerable and transitory side effects so keep that in mind.

McHale who had the rather dramatic sounding spitting up some spots of blood after his ablation for a while had a realtively minor intubation tube esophageal injury that required no intervention from an anesthesiologist that Dr Natale had just then started working with last May in NYC as McHale was literally the second person Dr N ever ablated in NYC at St Lukes, though no doubt some variable degree of throat or esophageal irritation or passing discomfort can happen during any intubation procedure, as others have noted here too, even with the most skilled anesthesiologist, as people have such a wide range of esophageal shapes and sizes.

McHale will be the first among many here to emphasize strongly to you that his whole experience has been entirely worth it for his now one year anniversary of clear sailing in NSR at the hands of the same maestro you are considering and who just completed Susan's procedure as well. And all because McHale had the good sense to way the risks and benefits of going ahead with the procedure in his clearly progressing case of paroxysmal AFIB that was heading toward persistence rather quickly at the time and to further minimize his stroke risk.

McHale, kindly jump in and convey your big picture assessment of your own overall experience here beyond just leaving off with the spitting blood image :-) . I spoke with McHale regularly doing his recovery and he handled it all quite gracefully and kept his eye on the big view.

Susan's very understandable and appropriate question and concern is being expressed still in the middle of very early healing when even a twinge or feeling of discomfort might bring up the question 'is something dreadfully wrong?' I'm willing to bet you all the potatoes in Idaho Duke and Liz that Susan too will join the large chorus of those here who have found the whole ablation process with an EP of similar skill and experience as hers both resorative and well worth it in the long run when the bigger picture perspective becomes clearer for her after this initial healing phase has run its course.

It's not always easy to recognize the forest for the trees when in the middle of a thicket. Better to take the end result view of those who have been there and done that long ago when trying to place things in realistic and proper perspective.

And as Dennis noted, everyone experiences and interprets pain stimuli differently . For some folks, what is noted as a passing minor to modest irritation, others with exactly the same degree of tissue irritation or burn will judge it as a dire five alarm fire surely implying to themselves that something terrible has gone wrong. This is only natural and is a big benefit of places like this where a bunch of old timers can describe what they too have gone through and experienced from the broader light of day to help everyone keep these things in perspective

Its important to know when some symptom is more or less par for the course and when you truly might need urgent intervention and, of course, while your doctor should be the first priority in confirming that for each patient, a board like this is invaluable to both keep our imaginations from running away with ourselves in the early days after an invasive cardiac procedure when we tend to be hypervigilant and there are many changes going in during the ongoing healing process. But also to know when something needs immediate attention for your Doc as well.

If Susan had first reported swallowing or esophageal pain anywhere from around day 8 on the early side, to two weeks on average after the ablation accompanied by other symptoms such as a substantial fever I would have urged her to immediately call her EP right away and he would have either had her come in right then or go to an ER for screening just to be on the safe side.

But what we have been taking about and sharing here in this thread so far has been the kind of relatively common and temporary issue that can arise after even very successful ablations that the person will be very happy to have gone through in the long run.

Just keep that in mind Duke when you are ready to run for the hills when interpreting some of these passing experiences in a too narrow context, all the while your progression of AFIB continues thumping away, laying down more fibrosis and scarring all the time while marching you predictably toward persistent AFIB and the major life impact this condition can impose on us all.

While this procedure in highly skilled hands can seem like a relative walk in the part compared to many, if not most, invasive procedures, there is still no real free lunch and you should be prepared for a tolerable period with some degree of discomfort in the early days and first couple of weeks after an index ablation ... Though in the end, most are surprised it turned out to be not as rough as they had expected before hand.

Cheers!
Shannon



Edited 1 time(s). Last edit at 05/21/2014 04:50PM by Shannon.

Susan - I'm so pleased you did so well.

Since I'm female and was 67 at the time of my Natale ablation, I was pleasantly surprised that the post-procedure recovery period was as easy as it was. After arriving home the afternoon of my discharge, I called friends and family to let them know I had 'survived' and I recall commenting that it was totally amazing that I just had the inside of my heart significantly burned and that I felt as good as I did. The only reminder was a tenderness in the chest if I bent over to tie my shoes. The most significant aftermath for me was the large hematomas that formed on each thigh from the groin insertion area. (I have low platelets and warfarin for me was a problem). The hematomas were both weird and somewhat tender but disappeared gradually over time. I followed the instructions to take it easy for a week..which I extended to 10 days and then began doing all my routine activities... including slow walking on the treadmill at the gym.

I attribute my excellent results and lack of side effects to all of the heroics I did intensely for six months prior to the procedure - making sure the core heart nutrients were optimized. I also took them with me to the hospital and as soon as I was able to get out of bed and move around, I resumed those I considered basic. I recalled being told on another surgical occasion to take high dose vitamin C to help with healing and lower inflammation so that was also included in my 'stash.'

My energy didn't fully recover until I was finally off the beta blocker and flecainide about 2 months later. Then, I felt a whole lot better as I have a low tolerance for those.

You'll be fine ... given time.... as long as you don't try to do too much too soon and if you are mindful of the nutrients that are essential to prevent electrical conduction problems. Refer to The Strategy with emphasis on the importance of the intake of high potassium containing foods and low sodium.... as discussed in CR 72.

I wish you a full and speedy recovery and a healthy, happy life in blessed NSR.

Best wishes,
Jackie

Susan;
I had my ablation with Dr Natale the same day you did and flew back last night. Like you, there was nothing functional about my life, the high HR, fluids accumulating and gasping for air trying to do even the smallest tasks. Life was on hold; business suffered, vacations cancelled, weddings missed. I went through the airport to Austin in a wheelchair, but I walked briskly to the gates on return - just seven days later. How can this not be some miracle especially after eleven months of permanent Afib?

There are not enough good words to say about Dr Natale and his staff. I tried to think of them and couldn't get past the" thank you's" but I think "you saved my life" was more in order. I had a years worth of experiences to try to correct the afib with other cardios and EP's who I'm sure tried their best, but it's been a nightmare of different drugs, then drug reactions, multiple cardioversions, hospital stays and zero successes and no follow ups. No one discussed treatments the way they did in Austin. They were honest in their approach and let me and my husband know what was going on throughout the procedure and stay and I know they will be there when I call.

After the experiences I have had last year, I can tell you I was more anxious than normal to fly across the country to the great unknown. But, what you read on these boards is really not all hype. The staff and Dr. Natale put me at ease. It really wasn't as bad as I expected. Lying still for 8 hours was difficult for me, but I preloaded some soothing classical music in the iPhone and had that going the entire time and it helped.

I did also have the raw esophagus and the Carafate while in the hospital, but after, found a few frozen yogurts and a giant malted at the airport did wonders ( can't be a better excuse for such indulgence). When swallowing, I might say it's slightly sore still but there is no bleeding ( unless I'm freezing it all and don't notice)

I know my procedure was extensive and I will have to go back for a touch up, but it is still worth it and I will do it again, this time without hesitating so long. Today I'm fully functioning at home and feel like I surely "resurrected".

Susan if have any other question, please feel free to write here or PM. I hope you'll soon feel as good as I do.

Hi AnnieK,

I'm so glad to hear you got your procedure done last week in a Austin too. I was there for a Lariat follow up TEE too. With Susan there and two other couples who recognized me in Dr Natale's waiting room and kindly expressed their gratitude to Hans and this website and all the frequent contributors for encouraging them to come there, we could have all had an 'afibbers.com' get together while we were all there :-)...

Anyway, am pleased you had Dr Natale taking charge of your challenging case and experienced the kind of care and skill he and his staff there can offer.

Best wishes with a quick recovery a step at a time after this biggest step taken in your ablation process toward a long term quiet heart.
Cheers!
Shannon



Edited 2 time(s). Last edit at 05/31/2014 02:16PM by Shannon.

Wow, the place was loaded with the "web folk".
You all are vets at this - I was probably too tense to party and still very short of breath afterward. I had to stay another day to get rid of extra fluid and hadn't slept in 3 nights so when I could I crashed very hard. I still knew I was better despite all of that. I probably let this go on way too long, but hopefully there's no damage. This was not an easy decision given other options nearer home.

Thank you for manning the web site - it's a good source of information, especially those first hand experiences. I'm a chemist by training and think everything should be cured with chemistry /nutrition but I tried every "additive" short of the rare Chinese mushroom that grows on some nasty underground worms - all to no avail.

Love to hear about successes and hope mine will be on the list soon.

Hello All
I want to say that Dr. Natale just called personally to check in on me which was SO nice. And as said in my first email we thought he and his staff the hospital were terrific. We were happy we traveled from NYC to Texas for the procedure.

Personally think all this back and forth has been GREAT! I think getting the information out that many people have varying degrees of either intubation aftermath discomfort or some level of pain from possible inflammation of the esophagus is all good. Now going forward anyone that reads this thread will be not as scared as Dennis or I were thinking they were going to be the 1% complication person.
Once you know what can happen and that all these other people turned out ok everyone relaxes. That is why this forum is so wonderful and necessary.

SHANNON - On betting on ALL the potatoes In Iowa... i would say at the moment (you said up to 8 weeks can happen), you and Natale were right again. It took 48 hours on the carafat and PPI but today.... after seeing a steady decline in feeling well and and increase in pain. since sunday night...today the pain is starting to get better. And while i still feel it a little when a swallow it is far better than yesterday. So lets hope i keep heading in this direction!
As for whomever thinks that people have different pain sensors they are probably correct but for the record i delivered one of my children with no epidural... i get real pain.
You all are wonderful and supportive ROCK STARS.
Wishing everyone NSR.
xo
Susan

Great news Susan, and you are most right, as Annie noted too, this place is marvelous for sharing and sorting out the variety of experiences that living with AFIB can bring ... Or more accurately, impose ... on our lives. And to hear the kind of reassurance when appropriate that is hard to feel and relax with if you haven't been down that road before when a symptom arises or feels more active for a while that many of us have gone through and not only survived but thrived in spite of afterward when all the dust settles.

I just think its great you both crossed the bridge of your most significant step toward real control over this exasperating condition on the same day with the same such very skilled hands at the helm for you both.

I was really concerned for you Annie with the situation and options you first presented here with and am relieved to see you made it to a man I really trust in handling such cases with such expertise. As you know, with more challenging case it can take a touch up to finally button down all the hatches and if such a step winds up being in the cards, rest assured to it will be a much easier overall experience even than this first one. Hopefully, life will throw you a bone and you'll be 'one and done' as it is.

Best wishes to you both,
Shannon

Glad to hear you are doing better, Susan, and that you have found this Board so helpful. I think we all find this is one of the only places we can go where everyone here "gets it", offer support and advice and helps us through the challenges we've all faced, to one degree or another.

I had a Natale ablation last Sept, in NYC, and did not have much of a problem afterwards with swallowing, or any other real problems. Some discomfort in my chest, but that only lasted a couple of days, as I recall. The worst problem I had was that my back was killing me when I got back to the recovery room! I must've been in some contorted position during the procedure, and then had a great deal of difficulty falling asleep that night, as it hurt alot. But the next day, I was fine. A little shaken...but otherwise good. It's now 8 months later and I am going down to Austin in a few weeks for a "touch up" ablation, as I had an episode of Flutter a few weeks ago, and needed to be cardioverted - my first time ever needing that in 10 years. Was hoping to be a "one and done", but I did have a LAA isolation and needed extensive work, as I had waited too long as I thought I had Afib basically under control - ha! Before starting Flecainide, I was getting Afib twice/day...but because I could make it stop through brisk walks, I thought I was handling it. Well...walking in all kinds of weather, late at night, early in the morning, before going to visit colleges with my son, while visiting schools, etc,, etc.that got old over time...Flecainide worked pretty well for me for 5 years, but then again, I had quite a bit of scaring on my pulmonary veins, so waiting didn't do me any favors.

I have also relied on Shannon, Jackie and other "gurus" on this Board to help me through tough decisions, challenging times, etc. and they have been incredible! I thank God for all of them, and for finding out about Dr. Natale - and am very glad that you have found this group and Dr. too.

Wishing you a very speedy recovery and a peek in a rear view mirror that shows your concerns and prior difficulties fading in the distance.

Best to you ~ Barb

Duke, a lot depends on how AF is affecting your daily life. I was gettting a few episodes a week. I dreaded them, even though a 300mg dose of Flecainide plus 60mg Diltiziam almost invariably got me back into NSR within a few hours. I didn't want to take the drugs on a daily basis so used them as a PIP. I had no left atrial enlargement, so I decided to go for ablation, after considering the risks (slight) and the alternatives. It still took me a little time to be 100% sure I wanted to go through with it.

The operation itself was almost a non event. I had a problem with the Foley catheter afterwards but that was about it. The main thing is, as I said in an earlier post, the instability that was there for a few months and not completely gone in my case for 7-8 months. But I can tell you the instability (PACs etc) wasn't there all the time by any means and was a lot better than the AF was especially once I understood what was going on (with the help of some monitoring by the EP clinic using a portable ekg).

I expect I was getting a lot of PACs before the ablation too, the difference being that they'd often lead to full blown AF.