afib and commercial drivers license in Canada (Ontario)

Has anyone had any experience with this in Canada.I was diagnosed with one episode of afib in 2012.After many tests including 3 days of holter monitor it showed up.(may 2012).Earlier this year I was seeing same GP about something unrelated when I mentioned that I thought I might be getting the occassional mild symptoms of afib. He asked was this some occasional flutter or more? Nothing more was said however about 4 months later he wrote "several episodes of afib 2012" on my annual drivers medical report.I told him I was worried about this being submitted to the Ministery Of Trans, to which he replied" dont woory they will ask for more info if they need it"............Well they certainly do want more info ,5 pages in fact! I went back to him and told him this is very stressfull /His only answer (in a rather casual way)was that rules change IT turns out when he did actually look at my record going back to 2012 it recorded one episode not several over a year...................Im now extremely worried about my drivers lic. being revoked and having no way of making a living Im getting afib everyday now along with anxiety attacks.......I dont want to go back to this guy ,I think that after 41/2 years he is just trying to cover for himself.......I wish I could get this under control as Im sure they are going to want more recent followup from 4 yrs ago.thanks KIrk

Kirk,

Its really is too bad your GP noted multiple AFIB events in 2012 when the Holter monitor caught only 1, in ;sight of the possible ramifications then on your commercial drivers license.. Yet now in 2016 since you really are experiencing more episodes, the best angle for you now is focusing on getting AFIB out of your life for the long haul which should really be every Afibbers prime goal.

It seems like you have had gradually increasing paroxysmal AFIB at least since 2012 and now you say you are 'getting AFIB every day now'.. the still implies paroxysmal but at as an advanced case now with daily episodes. Have you had any 24 hour or longer episodes and how long are your typical episodes and how often do they occur each day?

In any event, I would make my way to SouthLake and try to partner with Dr Atul Verma there who I know is a skilled ablationist and studied under world renowned ablationist Dr Andrea Natale at Cleveland Clinic back in the first half of the 2000 decade. I don't know if your insurance covers that same province of South Lake but its worth inquiring there first and ask specifically for Dr Verma.

Picking the most experienced AFIB ablation EP you can possibly arrange for your self even if you have to travel is the number one step toward long term success with the minimal amount of total work being needed.

In addition, and in the meantime, please read the document found inside the link at the top of this main forum page titled 'AFIB Resources' the document is found here:

The Strategy - Metabolic Cardiology This will tell you all about how to start and follow key heart calming electrolyte repletion with Magnesium, Potassium and the amino-acid L-Taurine that together have helped many afibbers gain some degree of improvement in both frequency and duration of AFIB episodes in some cases.

This protocol does not often lead to full remission, but it can very much help improve annoying ectopy (PVC- PAC) and achieve better cardiac stability overall which is certainly a good thing.

Also, its is key to do everything we can to address any not so good habits from eating poorly, drinking alcohol especially in excess, but to any degree while still prone to AFIB, smoking and to make a dedicated effort at improving any and all life style risk factors issues like Metabolic syndrome/Type 2 diabetes, Obstructive Sleep apnea, hyper tension and most importantly treating obesity if that is an issue for any of us.

Adopting better 'Self-Health' protocols you can learn about here, including smart dietary and exercise habits, are all important factors that really can make a big dent in your AFIB frequency and duration.

By learning to help improve your own health and reduce those risk factors that are known to promote AFIB and other cardiac diseases, is one of the very best ways to help give you a major leg-up on long-term freedom from AFIB. And doing so, will certainly help insure the best success from an expert ablation process when it too is needed, in addition to all the life style risk factor reduction good habits, in order to achieve the ultimate goal of long term freedom from AFIB and all atrial tachy-arrhythmias.

All this can, indeed, be achieved by following the well-vetted protocols and recommendation you will find on our website and forum ... as well as found in many of the past 141 issues of The AFIB Report newsletter you can access here as well.

We have found that most afibbers will require an expert ablation process in addition to improving their overall health to get the best success long term. You certainly came to the right place to get started and you will find many of us 'old-timers' here have already achieved many years, and even over a decade now, of successful freedom from AFIB.

Welcome, and don't get discouraged, just take it all a step at a time and ask questions here and gradually it will all become clear.

Shannon

thanks for the reply.My fear is is that the govt. will downgrade my license because of afib.I have type 2 diabetes and you cant have a chad 2 score and keep your heavy truck lic. in Ontarrio.They wont accept abilation ,only control through meds or you lose your lic,I have had a lot of stress ever since the doctor reported the afib from 2012(drivers medical submitted in Sept 2016).I only had a couple of episodes early this year lasting a few seconds.This atril fib has been acute since this medical report was submitted in sept..Its stress related I get it later in the day mostly at night,Im just worried about my ability to to earn income,its just stressing me out.....where is Southlake? thanks Kirk

Kirk,

Sometimes the other metabolic conditions, such as T2, can be a cause of afib. Hence if you can improve these conditions, the afib MAY improve. Toronto nephrologist, Jason Fung, has treats T2 with lifestyle and has been able to "cure" (which he defines as normal blood sugar and no meds) many (I would prefer the term "remission" as if you give up the lifestyle changes, the T2 will return). He has a video series here <[intensivedietarymanagement.com] A many part series on T2 <[intensivedietarymanagement.com] He has a 25+ post fasting series here <[intensivedietarymanagement.com]

His very successful approach relies on fasting. For afib, you want to be careful because as serum insulin levels drop, electrolyte shifts will occur. Specifically, high levels of insulin signal the kidney to retain sodium (a reason for the sodium linkage to high blood pressure). Conversely, low levels of insulin will signal the kidney to excrete sodium. This can be so dramatic that it can be the cause of what is known as "keto flu." See <[www.dietdoctor.com] Hence supplementing with sodium salt, potassium & magnesium is essential.

Good luck!

George

Geroge,,,,,,,Thanks for the info, Actually my t2 diabetese has been harder
to control as of late,I believe its the stress over my drivers lic.......I keep thinking how do I get the afib to stop if and when they ask for followup.Thats all I obsess about.I went to another doctor and he gave me lorazapam to try and level off the anxiety.I think Iam going to need to go for the full gammit of tests like 4yrs ago,as I cant see them saying no further episodes without some evidence...........Is doctor Fung available in Toronto? thanks for your reply ............Kirk

Hi Kirk,

The background on the program is here <[intensivedietarymanagement.com]
This is info on the in-office program with Dr. Fung <[intensivedietarymanagement.com]
This is info on a remote program: <[intensivedietarymanagement.com]

George

hi Shannon : wanted to ask is there a good resource for abilation in Canada.It would be expensive and not covered by any plan if done in U.S.(a lot of short terms used on this site,(by abilation are we talking catheter abilation?,),,,,,,,,,,also bought some magnesium caps and potassium at the drug store a week ago,,just the low priced store brand so Im not sure if its all that good for afib,,,,,,Also on one blood test I had a couple of yrs ago it showed minor kidney disfunction(my same GP negated it at the time and said there was another number on the test that was a better indicater, On another blood test the lab cautioned lower of range for red blood cell count and he said the same thing,,,,,,,,,,,,,,,,,,,I guess if there is a better more comprehensive indicater than why are they bothering to point it out or is it the GP who is not caring? thanks Kirk

Kirk,

From what I've seen over the years, Drs. A. Verma and Y. Khaykin at the Heart Arrhythmia Centre at Southlake Regional Health Centre in Newmarket, Ontario are the ones. I believe Verma trained under Dr. Natale. Here is a what others have said: <[www.afibbers.org]

George

Hi Kirk,

Welcome to the Forum, and I'm sorry you're having so much trouble. I'm surprised at your doctor and the MoT, because I live in Ontario and at no time when I had afib did any of my doctors - GP, cardio, or EP, suggest that I shouldn't drive. While you're deciding about ablation, if your afib is controlled either by your supplements or by meds, I can't see them suspending your license.

You say you have experienced more afib since the stress of this issue. Could some of what you're feeling just be ectopics, I wonder? You have only one documented case of afib, the others might be something a little more benign. Certainly your GP doesn't know, since he didn't verify it on an electrocardiogram, so you could question the accuracy of his report.

I do suggest getting a different doctor, and also seeing a cardiologist or EP for this rather than a GP. I had my ablation done at Southlake Hospital in Newmarket, Ontario and although the wait is long, it is well worth it.

Marg

Kirk

Once you decide on an ablation, the best place for AFIB Ablation in Canada is, as GeorgeN noted above, at Southlake Regional Health Center in Newmarket Ontario ... which fortunately, I assume, is the province you live so you should not have any trouble hooking up with Dr Atul Verma who is the EP I would chose were I needing an AFIB ablation in Canada. His Colleague Dr Khaykin is also very experienced too with some good reports about him as well. Dr Verma has trained with Dr Andrea Natale who is peerless when it comes to AFIB ablation, though it has been over 10 years since Dr Verma worked with Dr Natale it is still a very good association to have had when he was at Cleveland Clinic when Dr Natale helped build CC's AFIB Center into a true world renowned research center when he was still there leading that program.

Dr Natale is now at St Davids Medical Center in Austin Texas which ihe has build over the last nine years into the largest and most respected ablation research center in the worl. Along with several other elite centers like University of Penn and the famed Bordeaux group in France where some Canadians go as well to mention a couple other very reliable ablation centers. There are a fair number other top centers as well in the US, but I suspect you will focus on the best in Canada. The cost is around 15,000 Euro, out of pocket, for the full ablation at Bordeaux for those from other countries that lack EU insurance.

You can get a complete index ablation (that means your first procedure) in Austin Texas at St Davids Medical Center with Dr Natale himself for $40,000 US. which is well worth it if you can afford that. But Dr Verma is very likely to help you as well an right in your backyard almost. You may have to wait a while like for many such procedures in Canada but that is okay, it s always worth waiting for the best AFIB ablation expert you can possibly arrange for yourself even if you have to travel for 5 days or so for the whole process.

Plus doing any weight reduction, if such a step is warranted in your case, I also strongly advise embracing up front as well as dealing the best you can with your Type 2 diabetes and Also if you have obstructive sleep apnea to treat that as well. If you have more weight than is ideal for you, then work on losing at least 10% of any excess body weight, but only if that is an issue for you. These steps can really help reduce your AFIB burden as can electrolyte repletion if magnesium and potassium as needed and referred to in an earlier reply to yoy. Addressing any and all of these Life Style Risk factors can really help insure the best outcomes from an expert ablation as well, if and whenever you decide such an ablation is the way to go for you as well as improving your overall cardiovascular health.

My emphasis here on ablation is primarily in light of your unusual scenario with the risk of your commercial drivers license to sustain your livelihood so that you have the basic info about wise choices in Ontario and elsewhere for quality ablation care. Not that you are otherwise in dire need of an ablation at this time based at least on your limited reported AFIB history. I concur with Marq, Jackie and GeorgeN on this point and urge you to dedicate yourself to RFM (risk factor management) and adopting as many good 'self -health' habits as you can sustain.

Best wishes,
Shannon



Edited 2 time(s). Last edit at 12/01/2016 01:08PM by Shannon.

Hello Marg : thanks for the reply.Maybe I should be a little more detailed about afib and other cardio health issues in Ontario Canada.Here if you hold a class A-Z licence or anything under that class (az) being tractor trailer you are required to go for a physical every year after 65 yrs ,its less frequent between 45-65 yrs of age.They are much less tolerant of drivers of heavy vehicles given the higher risks of accidents..They are particularily(sp)? concerned with the potential for what they call LOC.or loss of conciousness.Thats where afib comes in and the hightened risk of stroke that they see..If afib can be controlled with meds along with a doctors care than you can usually keep your licence.There can be no record of loc which there is none in my case.......Not to downplay the everyday problems of people with afib but most doctors are not going to worry about your average car driver with afib....Its when you go in with a form for the doctor to complete (a complete physical) that things change).....I had one episode of afib after 3 days of a holter monitor in june 2012 and he decides to report it in sept 2016??.......this is all because I mentioned to him months before that I wondered if I might have detected it again although very breifly ........he was in a hurry and we have socialized medicine here and he was just covering his behind.........What are ectopics? I have a bp moniter with pulse on it..My pulse is rarely over 80 and if I take sotatol it can drop to below 50(also feel this odd light pressure in my chest with sotatol.......I went to an ADHT specialist and got some lorazapam and the combo seems to settle me down,,I curse this GP that I have seen for about 15yrs.........The MTO are now on my case and want pages of info. Sorry for the long rant.....(does anybody know if those portable ECG machines are of any help?.......thanks Kirk

hello Shannon ,thanks for the reply.AS far as the type 2 diabetes goes my last a1c was 6.2 July16.Im about 6ft and maybe 170-172lb.Lost about 35lbs in last 6-7 yrs..I dont believe i have sleep apnea but I do think I need to start out with good hydration and magnesium its just that the cheap stuff at the big stores is not supposed to be that good..........is there a particular brand here you would suggest?.....thanks Kirk

Hi Kirk,
From the Mayo Clinic: Ectopics - Premature ventricular contractions (PVCs) are extra, abnormal heartbeats that begin in one of your heart's two lower pumping chambers (ventricles). These extra beats disrupt your regular heart rhythm, sometimes causing you to feel a flip-flop or skipped beat in your chest. Premature ventricular contractions are very common — they occur in most people at some point. When I feel them, I'm always taking my pulse just to be sure I haven't gone into afib.

It sounds to me as if your GP isn't very familiar with afib, which is not surprising, because often even cardiologists aren't as knowledgeable as we would like them to be. I would ask your GP to send you to a cardiologist so that you can get your afib issues dealt with - if you need to be on meds, or perhaps to have them sign off on your ability to drive without heightened risk of stroke or loss of consciousness.

Like a lot of people on this forum, I use Doctor's Best Magnesium Glycinate which is not very expensive, and available at IHerb. Here is the link: [www.iherb.com]

I went to Southlake for my ablation with Dr. Y. Khaykin, who studied with Dr Natale along with Dr A. Verma, and who is also excellent. I had the ablation four years ago and have had no afib since the ablation. But if you have had only one episode of afib, you are a long way from going down that road yet. I suggest you try the supplements and The Strategy as a first step.

Best of luck.

Marg

Hello Marg I think what I may have is these ectopic episodes rather than afib.If the only objective finding was from a holter monitor over 48hrs in 2012.Is it possible to miss diagnose afib when its actually PVC?.....Healthy Planet does not carry doctors best (its close by)Is there another good magnesium supplement? thanks Kirk.............In 2012 I went to a cardiologist,did stress test, echo,ecg,holter moniter.....thanks Kirk

Hi Kirk,

If you had on a Holter monitor, I would say that episode was afib. But the other flutterings you were feeling afterward may have been ectopics.

I order my magnesium from iHerb. Delivery is very fast - sometimes even the next day but definitely within the week. If you prefer to buy it locally, maybe someone else can weigh in on what would be a good one.

Marg