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My Ablation With Dr Natale (07/20/2018) with current updates

Posted by rocketritch 
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rocketritch
My Ablation With Dr Natale (07/20/2018) with current updates
July 18, 2018 06:25AM
This thread will cover my ablations with Dr Natale and I will do my best to keep it current along the way. Enjoy.

They say that time flies and it surely does.

Failed ablation in January, Medications I had been using for years stopped working. Cardioversion in April. Then starting new medications (Ticosyn) shortly after that worked spartically. Now in just a few days I will be having an ablation with Dr. Natale.

My last dose of Ticosyn was Friday evening and I started to taper off the Metoprolol. I will continue to tale Elequis straight through. I didn't have to stop the Ticosyn until Sunday but I spoke to my nurse and asked if it would be OK to stop a day or two early as I wanted to be certain that as much of it was out of my system as possible before the ablation. She said that would be fine so I did. I'm also down to a single dose of metoprolol.

Now the weird thing is that I have had nothing but issues since starting the Ticosyn. It didn't keep in me rhythm all the time. Sometimes I would stay in NSR for several days and other times several hours. Even up until last week I was in and out of rhythm a few times. But since I stopped on Friday I have only had a few stray odd heartbeats.Now I am not complaining as I figured I would be out of rhythm and miserable until Friday.

Don't get me wrong. I am more than happy to not be miserable but it does strike me as odd. Especially with all the issues I have had up until this point. Anyway, I am leaving for the airport soon and have an appointment for a CTA and I will finally get to meet the nurses and Dr Natale tomorrow in Austin. Needless to say I am excited.

I also want to thank everyone here for their kindness and support along the way. I also want to recognize Shannon and his passion for this site and for helping people.



Edited 4 time(s). Last edit at 07/19/2019 07:45PM by rocketritch.
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mwcf
Re: Ablation With Dr Natale This Friday
July 18, 2018 07:04AM
Austin and Natale sounds like a helluva plan to me!!

You're in great hands this coming Friday (-:

Best,

Mike F.
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AB Page
Re: Ablation With Dr Natale This Friday
July 18, 2018 08:48AM
You're in great hands, the best. Safe travels. Here's to the very best of outcomes. Shannon and Dr. Natale and TCAI/St. David's are the cream of the crop.
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vanlith
Re: Ablation With Dr Natale This Friday
July 18, 2018 09:25AM
You mind is your heart to some degree so now that your relaxed and so full of anticipation of getting this done with THE master tech. himself........prob. your cortisol levels are perfect and your brain is being flooded with good chemicals.
Its like the natural reaction when 1 gets to an emergency room visit when your name is called or hearing the door bell ring and know its the doctor on your doorstep and you feel that finally help is on the way and a great relief comes over you.
I hope i feel just like you Ritch in few months when i go see Da Vinci also......dates and so on for me will be finalized in a few weeks.
How about that Shannon. I am wondering how a person in our state or even 1 with just a pinch of afib/flutter/tach could not go to see Dr. Natale after listening to Shannon. What a wealth of knol. of afib, Dr. Natale and the whole industry as a whole. He was nice enough talk to me for about 90 min. and as i said in another thread i was on the edge of my seat the whole way and cannot remember feeling better after a phone call maybe in my whole life. Him the people at St. David hosp. in austin have made this exper. so wonderful and everyone seems so caring i cannot wait to get show on the road like you.
I come from Canada....aka assembly line health care so its an incred. exper. to be treated this way.
Keep us updated on everything that happens...I for one cannot get enough so many updates would great.
All the best Ritch.



Edited 1 time(s). Last edit at 07/18/2018 09:28AM by vanlith.
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pandapab
Re: Ablation With Dr Natale This Friday
July 18, 2018 10:39AM
Good luck to you!
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smackman
Re: Ablation With Dr Natale This Friday
July 18, 2018 11:16AM
You will be in good hands with Dr. Natale. I have had 2 Ablations with Dr. Natale. St. David’s is the best. My Nurse Case Manager Curry is a Gem. Its all good from here my friend.
Shannon is a wonderful person who was so helpful to me plus so many on this forum. I was a lost “ puppy” in late 2011 when I found this forum. I thank God daily for leading me here.
Happy NSR days are Soon my friend.
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Billyjeans
Re: Ablation With Dr Natale This Friday
July 18, 2018 01:25PM
I hope you have great success. Keep us posted...
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ln108
Re: Ablation With Dr Natale This Friday
July 18, 2018 11:05PM
All the best to you. As others have said, you're in the very best hands.

--Lance
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Carey
Re: Ablation With Dr Natale This Friday
July 19, 2018 12:55AM
Can I say it one more time? You're in the best of hands. Good luck and let us know how it went as soon as you're able.
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rocketritch
Re: Ablation With Dr Natale This Friday
July 19, 2018 07:49AM
Arrived here in Austin last evening. Went to get a bite to eat and spoke with Shannon.

Not long after that I went out of rhythm. Eating had become an issue at one point when I was on the Ticosyn. So I was not shocked when it happened.
Stayed out of rhythm most of the night. So much for all the hydrating I did yesterday 😁.

Anyway, I'll be catching an UBER here in a little while as my CTA is scheduled for 10am and they want me there by 9am. So I'm hoping to be there by 8am.

Never used UBER before so hopefully that will go smoothly.
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GeorgeN
Re: Ablation With Dr Natale This Friday
July 19, 2018 08:39AM
Quote
rocketritch

Never used UBER before so hopefully that will go smoothly.

My experience in a busy area like Austin, has been excellent. Hopefully all goes well this & your ablation!
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Jackie
Re: Ablation With Dr Natale This Friday
July 19, 2018 09:12AM
Joining in late to wish you the very best. I have no doubt all will go well for you and you'll soon be posing about your
fantastic Austin experience.

Jackie
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ragatx
Re: Ablation With Dr Natale This Friday
July 19, 2018 11:25AM
Hey Rocketritch,

I've also got an ablation with Natale tomorrow. We'll probably be neighbors. smiling smiley

Hope your procedure goes smoothly and your recovery is quick!

-Tony
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rocketritch
Re: Ablation With Dr Natale This Friday
July 19, 2018 01:15PM
Quote
ragatx
Hey Rocketritch,

I've also got an ablation with Natale tomorrow. We'll probably be neighbors. smiling smiley

Hope your procedure goes smoothly and your recovery is quick!

-Tony

I just saw your post and was thinking the same thing.

Good luck to you as well. No need to worry. I've had 2 ablations over the years, not with Natale though. I'm a slow learner.

Your are in the absolute best hands to start out with.

Maybe we'll cross paths.
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rocketritch
Re: Ablation With Dr Natale This Friday
July 19, 2018 04:06PM
Had my CTA and consultation with Dr. Natale today.

I have never had a CTA before. Very interesting process. And the feeling you get when they inject the contrast dye is IMHO very pleasant.

As to Dr. Natale, I was very impressed.
Very pleasant and he is so relaxed and very interactive. Very warm personality. Great first impression.

The staff I have had interaction with. Both at TCA and St. David’s has been stellar.



Edited 2 time(s). Last edit at 07/19/2018 10:09PM by rocketritch.
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ragatx
Re: Ablation With Dr Natale This Friday
July 20, 2018 09:45AM
Good luck neighbor!
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AB Page
Re: Ablation With Dr Natale This Friday
July 20, 2018 10:12AM
Quote
rocketritch

I have never had a CTA before. Very interesting process. And the feeling you get when they inject the contrast dye is IMHO very pleasant.

It's certainly an....odd feeling. Getting you all the feels right there in your business area. I'd had this done before, but for some reason the one at TCAI made me nauseous for a short period after. They told me ahead of time that may happen.

Again, best to both of you.
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rocketritch
Re: Ablation With Dr Natale This Friday
July 20, 2018 10:31AM
Quote
ragatx
Good luck neighbor!

Same to you.
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rocketritch
Re: Ablation With Dr Natale This Friday
July 20, 2018 06:09PM
Up and about.

LAA, Coronary Sinus and Posterior wall. I think. Was up and about but still kind of out of it when Dr Natale came in.

Will get better clarification tomorrow.

He was impressed with my 220 bpm 💓-rate.
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vanlith
Re: Ablation With Dr Natale This Friday
July 20, 2018 07:59PM
220 bpm..that must have been when he put the 20 or 30 ug's of isoproterenol in you to find any lingering afib/svt/flutter culprits after he thought he got em all or maybe after just the PV's and post. wall. What's your rate now...must be around 80-100 bpm my guess...btw you must be lying on the gurney with a phone in your hand right...if so that's what i call dedicated to giving his fellow affibers almost real time info. That's a lot of ablating....if that's what Natale did cause he normally just does the PV's and post. wall for rotors ect. in your basic case and then moves on if nes. to the coronary sinus next then LAA and vein of marshall in % of possible 2nd and 3rd or more culprits. Well look at it this way he pretty much covered your whole heart grid by grid so i cannot see any chance of anymore afib flare up spots hiding there. Well the LAA work if he did indeed iso that will require you to take a blood thinner now but that's a very small price to pay for letting Da Vinci paint that beautiful picture on your heart toward nsr bliss...keep us posted....its too bad you could not have givin us the play by play in real time during the branding iron session itself.....o well this was close as i have ever seen. When i get this done in dec. i will ask Dr. Natale to wake me up mid procedure so i can update you guys and see what he says.
GL..keep up us posted during supper, showers, bathroom breaks ect. how you feel and bpm.



Edited 1 time(s). Last edit at 07/20/2018 08:04PM by vanlith.
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rocketritch
Re: Ablation With Dr Natale This Friday
July 20, 2018 10:03PM
Quote
vanlith
0 bpm..that must have been when he put the 20 or 30 ug's of isoproterenol in you to find any lingering afib/svt/flutter culprits after he thought he got em all or maybe after just the PV's and post. wall. What's your rate now...must be around 80-100 bpm my guess...btw you must be lying on the gurney with a phone in your hand right...if so that's what i call dedicated to giving his fellow affibers almost real time info. That's a lot of ablating....if that's what Natale did cause he normally just does the PV's and post. wall for rotors ect. in your basic case and then moves on if nes. to the coronary sinus next then LAA and vein of marshall in % of possible 2nd and 3rd or more culprits. Well look at it this way he pretty much covered your whole heart grid by grid so i cannot see any chance of anymore afib flare up spots hiding there. Well the LAA work if he did indeed iso that will require you to take a blood thinner now but that's a very small price to pay for letting Da Vinci paint that beautiful picture on your heart toward nsr bliss...keep us posted....its too bad you could not have givin us the play by play in real time during the branding iron session itself.....o well this was close as i have ever seen. When i get this done in dec. i will ask Dr. Natale to wake me up mid procedure so i can update you guys and see what he says.
GL..keep up us posted during supper, showers, bathroom breaks ect. how you feel and bpm.

You only edited that one time?^^^^^^ Now I’m impressed 😂

Heart rates been between 83-94. Did see it go to 101 just before supper. Sorry I did see your post before I could have Skyped it over dinner. The catfish was splendid BTW.

Anyway, I feel really good right now and the fog has cleared. He said that PVI scarring from previous ablations was good. I’ll need to clarify if he actually did anything there (He did do some PVI work. He expanded the scar tissue on all 5. He also did some work in my right atrium. Not sure if he did this before he punctured through or as he was coming out). I have had flutter addressed before as well. But otherwise it appears he didn’t just take the .10 tour. He did say that everything looked good amd worse case I may need a touch up of the LAA down the road. The 240 heart rate was organic. It lit off as he was starting to work on the coronary sinus.

So far as the heart 240 rate I’ve seen that before. Very first time was back when my Cardiologist sent me for a stress test in the very early days so I was still in my mid to late 20’s. They put me on a treadmill (I had requested a bike) and stared pacing me. They kept increasing the speed and asking me if I felt alright I said yes and started a conversation with the tech. He was having non of that so he kept bumping it up and I kept talking. At one point after he and another technician started to look at me as if I had spiders crawling out of my ears they concluded the test. Said that was the first time they ever ran that machine that fast.

They then took me to a room, had me lay down and watch my rate drop. A Dr came in and talked to me and looked at my strip. He looked st me again then turned to the nurse and said leave me hooked up for a while longer. This whole time I had been watching the screen as my was dropping. 140,130....... 100,90,80.......BOOM........ 240. Alarms and mayhem from my nurse ensued. She looked at the monitor then at me back at the monitor then she was off like a shot as I tried to say something to her. All I could hear was here yelling Dr. DR getting further and further away. I just laid there shaking my head smiling to myself as she had left me alone.

Finally I saw her running back up the hall towards me with the Dr trailing way behind. When he finally arrived he looked at the monitor, at this point I was below 200, then he looked at the strip, then he looked at her for a moment. He then looked back at me and said “come see me, go ahead and unhook him”, then left. She then unhooked me as I was back in sinus and led me to the discharge area. I never did see that doctor again as I had already been through several cardiologists to this point and had one I liked. So I never did get to find out what he was thinking. He may have been an EP for all I know.

I’ll update tomorrow after speaking with Dr Natale.



Edited 2 time(s). Last edit at 07/21/2018 06:15PM by rocketritch.
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vanlith
Re: Ablation With Dr Natale This Friday
July 20, 2018 10:28PM
That runaway rate was prob. linked to the problem you just had addressed.
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rocketritch
Re: Ablation With Dr Natale This Friday
July 21, 2018 11:33AM
Just talked to Dr Natale. He seemed very pleased and wants to see me in 6 months. Since I am on the younger side I asked him about the watchman device. He said that we could talk about that when I come back.

The high rate he spoke of was organic and was 240 bpm not 220 as I posted before. He said it happened as he was starting to ablcate the coronary sinus. Also said he rarely sees that high of a rate. They had stared me on Ticosyn here but he and I had discussed going back to flecanide. He left that decision up to me so I will have to give it some consideration. The Ticosyn wasn’t keeping me in rhythm but the flecanide had stopped working. Also my back pain has gradually subsided since stopping the Ticosyn last Friday so I’m in a quandary as to which to choose.

I’ll be getting out of here today sometime and hope to be able to catch a flight home a day early (Monday), and join my family at the beach for a couple days. We will see.
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vanlith
Re: Ablation With Dr Natale This Friday
July 21, 2018 01:22PM
Well lets hope you have to go on zero rate drugs from here on in or this whole thing would have only been of limited success.
IMOP PIP only is the way to go through the blanking period if at all cause if it comes back normally as we know in the blanking period its not as intense and shorter than before....much shorter normally, unless it was a failure like mine, so maybe just ride it out if it comes back like many just do with no drugs other than blood thinners of course.
If you do decide to go PIP...well flec. seems out for you try propafenone during the blanking period....its a miracle drug for me in the PIP mode and i cannot imagine my life without it as a bridge between this horrible afib (about 6 ep. a month) to a final hopeful fix with the good doctor later this year. Discuss it with your doctor or just ask him for it like i did after a hosp. visit 3 years ago when 3 zaps of cardioversion did nothing for me and then 2x150mg propafenone converted me in just under an hour after 50 hours of hell. At that point i made an app. with my GP and asked/told him this is my bridge drug and he was ok with it then wrote me my 1st of many persc. of it and life has been so much better with 1 hour or less ARR's these days compared to 50 hours or less in the past...day and night, but hopefully this is mute point cause there is no reason you cannot be NSR from here on PERIOD.......esp. considering WHO was just in there working on you.
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rocketritch
Re: Ablation With Dr Natale This Friday
July 21, 2018 02:40PM
It's my understanding, and please correct me if Iam wrong, the antirhythmic drugs are used to keep the heart in rhythm as much as possible during the blanking period. And if an eppisode does occur tte shorter the better. I thought this was even more important for more complex/long standing arrhythmias.

The reason for this I thought is to prevent the heart from creating new pathways. Again this is only my understanding I'm no expert.



Edited 1 time(s). Last edit at 07/21/2018 02:42PM by rocketritch.
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vanlith
Re: Ablation With Dr Natale This Friday
July 21, 2018 04:17PM
Your correct ritch about trying to keep your heart in NSR no matter what it takes absol. but in your new condition its like a trial and error situation your in cause you currently and for the next few months are not sure what to expect from your heart as compared to a few days and weeks ago when you knew what to expect.
This is what i would do if i were you.....NOTHING.....at least until you get another ARR.....now lets hope you don't but if you get 1 or even 2 more anytime soon again.....nothing.....observe it time it see how long it is and then with that info decide if you want to use drugs....cause it may only last a few hours or less and the 2nd if it comes may be even less severe esp. if the 2 come spaced out a few weeks....the big point i am making is don't take your heart too seriously in the next 2 months don't overreact unless your heart really starts going wacky in the next few weeks with long ARR. run ons and freq. with little diff. from before then its prob. time for that PIP drug bridge until you see Natale again but until you see yourself deteriorate to that level just sit back and observe only.+++++++never lose sight that NATALE just worked on you..... the BEST EVER......the stuff that i have read about his work...... unless your a real complex case is your at very MIN. for short term meaning months and possibly a few years are going to be perfect....its maybe 3 years or more years down the road that i have observed that a few cases have gone somewhat sideways and only then have a few come back for touch ups.
Natale puts his rep. on the line in every 1 of his patients and that means YOU......he won't let you down......now no more negative thoughts (and that includes me).....just enjoy the sweet beat.....i envy you.
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rocketritch
Re: Ablation With Dr Natale This Friday
July 22, 2018 09:01AM
Feeling really good today. The chest pressure this morning is pretty much gone. I'm sure as I move around today it will build some.

I've lost just about all the fluid weight as well which I'm sure is contributing to my feeling better.

Was able to move my flight up to tomorrow so I'll be back home Monday instead of Tuesday.

This whole experience here in Austin has been great.

I also was looking at some things and back in 2009 on the same day of my CTA scan this week I got the time and date for my very first ablation which took place 1 week from today which would have been July 29, 2009.



Edited 1 time(s). Last edit at 07/22/2018 09:06AM by rocketritch.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 22, 2018 11:36PM
Quiet day today. Laid around all day and had a nap. Chest pressure was basically gone today and my blood pressure feels like it's back to normal. All those extra fluids you get during the ablation really increase your volumes. Gained a little over 3.5 lbs. This is the first time I have ever been given diuretics beyond the interveinous one they give in the hospital. Those really make a difference in relieving the chest pressure.

Had a couple runs of PVC/PAC's this afternoon. Nothing that lasted more than 30 seconds or so. Nothing out of the norm following an ablation and nothing since then.

Was able to get my flight changed so I'll be heading home tomorrow.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 23, 2018 10:10PM
Travel day today. Up early for a light breakfast then laid around the hotel until it was time to leave for the airport.

Flew out of Austin around noon. Back in Pittsburgh around 7pm.

Heart was quiet today. Chest started feeling a little sore later in the trip. Used airport assistance all day and took it as easy as I could.

Chest feels fine now.
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vanlith
Re: Ablation With Dr Natale This Friday 07/20/2018
July 24, 2018 08:37AM
Do you notice any increase in your HR rich?
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 24, 2018 10:02AM
Today is the first I have measured it since leaving the hospital. Sitting here in my man chair its 61 bpm.

Had a really good nights sleep last night. Started back on potassium amd magnesium last night.

Currently taking Ticosyn, metoprolol and elequis. I’m going to talk to Joaquie today and get a script for flecanide. I feel more comfortable with that



Edited 1 time(s). Last edit at 07/24/2018 10:05AM by rocketritch.
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vanlith
Re: Ablation With Dr Natale This Friday 07/20/2018
July 24, 2018 11:49AM
Since he worked on your LAA in some way are you on blood thinners forever now because of that and most importantly when are going cold turkey on these many drugs your mentioning other than ELQ. cause is that not what you went through all this for in the 1st place and of course to get back in NSR.....i am guessing during and late in the blanking period you will be withdrawing from them.



Edited 1 time(s). Last edit at 07/24/2018 12:03PM by vanlith.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 24, 2018 12:15PM
Quote
vanlith
Since he worked on your LAA in some way are you on blood thinners forever now because of that and most importantly when are going cold turkey on these many drugs your mentioning other than ELQ. cause is that not what you went through all this for in the 1st place.....i am guessing during and late in the blanking period you will be withdrawing from them.

Will remain on drugs for at least a month. Thinking about switching from Ticosyn back to flecanide though. He had no real preference.

Since the LAA work anticoagulants will be part of my life for now. They will test function of the LAA when I go back in January. However,even if functionality is fine they probably will not have me discontinue the elequis especially since the LAA starts to become a risk factor under normal conditions at my age. We had a brief discussion about the Watchman device and will discuss it further when I go back in January. There are two issue with the Watchman.

First and foremost is insurance. They don’t want to cover patients in my category, younger and physically active (ie. high risk for bleeding), for some reason. Secondary to that is the possibility of him maybe having to revisit the LAA for more work. He didn’t mention that but I’m just speculating as he is unable to be as aggressive in that area due to structure and proximity to the coronary vein. I would guess that if a Watchman Device was implanted now it would limit him in that area.

Another thought on the anticoagulants is that to address the afib the LAA needed work. To not address that would have left me in a position where I would have had to remain on them anyway. So worse case I end up selling my dirt bikes and stop mountain biking. I’ve pretty much given up on mountain biking anyway as I can’t afford broken bones at my age. I much prefer road riding anyway. And I’ll take the money from the dirt bikes and buy a convertible.



Edited 1 time(s). Last edit at 07/25/2018 08:42AM by rocketritch.
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Brian_og
Re: Ablation With Dr Natale This Friday 07/20/2018
July 25, 2018 06:19AM
A question re going out of town to Austin etc to get an ablation. Do you need to have a local EP to work with you before and after?
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 25, 2018 08:51AM
Quote
Brian_og
A question re going out of town to Austin etc to get an ablation. Do you need to have a local EP to work with you before and after?

From here on out Dr. Natale will be my arrhythmia EP. In other words nobody else would do anything inside my heart but him. He also wants me back in January for my follow up TEE. This is when they will look at the function of the LAA and make determinations/recommendations on anticoagulants or further steps such as the Watchman Device.

I will continue to work with my current local EP for basic follow up checks and so forth. He had already offered to do that for me along with any help he could be to get me in to see Dr. Natale.

Like I said before, your Dr should be vested in your health regardless of weather or not they are capable of helping you or if they need to assist you in finding someone who can.
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Jackie
Re: Ablation With Dr Natale This Friday 07/20/2018
July 25, 2018 11:55AM
Hi Brian - Yes, you should have an EP who can help you if you should need cardioversion. When Dr. Natale was here at the Cleveland Clinic, that was great. When he went to Texas, there were a couple of associate EPs here who were more than willing to help when I began having recurrent events 11 years later. However, knowing I would most likely need a another ablation for a-flutter when that surfaced, I knew I'd be going to Austin for the second ablation.

Then, while traveling home from Austin to Cleveland after the second procedure, I went into a-flutter again in the Nashville airport (connection) so immediately upon arrival at home, I called the local EP to get on the schedule for ECV. it was a great comfort to know I had a reliable contact I could call when I got home so I would urge you to set up something similar just in case you'd need it. Chances are, you won't need it but better that way than feeling desperate.

Best to you,
Jackie
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Brian_og
Re: Ablation With Dr Natale This Friday 07/20/2018
July 25, 2018 01:32PM
Thank you. I guess the next question is if I ever feel that I needed an ablation and want someone like Natale to do it, how do I find an EP that ok with taking care of before and after? Or would working with a good cardiologist work?

Kinda like walking into someone's office and saying "can you help me? But I don't want you working on me" 😊
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 25, 2018 01:44PM
It's possible that depending on where you are located that Dr Natale may have a contact near you.

Your cardiologist may be able to refer you to someone as well knowing the situation up front.

Also, just because they won't be Ablating you does not me that they can't help you. There is testing and even rutine Dr visits that are all part of it.
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Carey
Re: Ablation With Dr Natale This Friday 07/20/2018
July 25, 2018 09:05PM
Quote
Brian_og
Thank you. I guess the next question is if I ever feel that I needed an ablation and want someone like Natale to do it, how do I find an EP that ok with taking care of before and after? Or would working with a good cardiologist work?

If their ego can't handle you using Natale for an ablation and asking them to be your local clinical EP then walk away. No EP worth their salt would have a problem with that. No, don't substitute a regular cardiologist. My EP was actually relieved I went to Natale and fully supported my decision even though he had been my EP for two years, had done two prior ablations, and was highly regarded. I admired the hell out of him for that attitude and consequently I still do routine followups with him and seek his advice on things such as the Watchman procedure I'm going to do next week.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 25, 2018 10:16PM
Carry is absolutely right. My EP of 9 years. That performed 2 ablations and ii fairly whell reguarded himself was also more than willing help.

He is the one that told me that it was his goal to see me well. Weather it was he who was able to help me or in finding someone who could
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 26, 2018 08:39PM
It’s been a nice quiet couple of days. Heart is still purring along@ 65 bpm. Messed around in the garden yesterday. Went and retrieved my 4 footed companions from the kennel today.

Just got home from a friends house for dinner and ready for a quiet evening on the deck.

Still experiencing some fatigue if I am up and about for too long. Nothing out of the ordinary though.
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vanlith
Re: Ablation With Dr Natale This Friday 07/20/2018
July 27, 2018 08:02AM
Do you have a pocket heart monitor rich?
When i go in dec. for mine they offered me either a pocket carry one or an implantable one that last for 3 years but i think i will decline both because i am so aware of my beats to the point even in my sleep i wake up when i get some pac's let alone an ARR. so i don't need any monitors to let me know how i am doing...sounds like you rich...you feel everything too it seems.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 27, 2018 10:01AM
No pocket monitor. They did send home a HEARTRAK device to send weekly recordings which may be what you mean. I’m going to order a Kardia though. I do have a WAHOO heart rate strap that is Bluetooth and can link to my phone but that’s really only good for tracking current heart rate.

As far as being in tune with my heart, I am too a fault. And have been that way since the very early days. I really try not to be though as I have found that focus can cause issues. I remember in my younger days while out on training rides with friends. The mere mention of how my heart was doing could trigger an event.

I was discussing this with my friend and his wife last night. The hardest part right now, and I remember going through this following my other 2 ablations, is ignoring my heart. You really become focused during this stage, almost obsessive and that’s not good because it makes it nearly impossible to relax. And being in tune with how you feel only exacerbates the situation. Especially if your heart rate climbs to a high NSR rate under normal circumstances.

This happened to me several months following my first ablation back in 2009. I’m an avid archery hunter. Not as possessed as I was back then now though. Anyway, I was just nearing the end of the blanking period and had been feeling really good. The only event I had had to that point was when I had a afib event in the hospital following my ablation, before they started me on the arrhythmic drugs . I had been on stand for about an hour and a good mature 8 point was approaching my stand. The adrenaline kicked in and so did my heart. Completely threw me for a loop. Bow down, and fingers to my neck to feel my pulse. It was completely normal, only elevated due to the adrenaline rush. Needless to say I was relieved and chuckled to myself as the buck walked away.
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vanlith
Re: Ablation With Dr Natale This Friday 07/20/2018
July 27, 2018 10:50AM
HeartRak...did they suggest or tell you to have that....how many hours in a 168 hour week does it send back info?
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 27, 2018 01:09PM
HEARTRAK. It doesn’t do loop recording. I just hold it to my chest and hold the record button once a week or when I have an event.

I’ll start using the Kardia when I get that.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 27, 2018 10:38PM
1 week since my ablation. Feeling really good.

Family got home this evening and I ran out to my mennonite friends house for some home made ice cream. Had a scoop of blueberry and brought a quart of peach home for everyone else.

He makes some serious ice cream from an old family recipe. He also doesn't use any chemicals for cleaning his equipment. Only soap and water and always passes his inspections.



Edited 1 time(s). Last edit at 07/28/2018 09:54AM by rocketritch.
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vanlith
Re: Ablation With Dr Natale This Friday 07/20/2018
July 28, 2018 09:07AM
Thats great rich.....do you have any shortness of breath and i don't mean just doing normal things i mean have you walked up a few flights of stairs or walked at a good pace for a couple min. ect....when do you plan to start pushing things a bit?
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 28, 2018 10:22AM
Quote
vanlith
Thats great rich.....do you have any shortness of breath and i don't mean just doing normal things i mean have you walked up a few flights of stairs or walked at a good pace for a couple min. ect....when do you plan to start pushing things a bit?

I do have shortness of breath and fatigue if I am up and aout for too long. The nerve pain is returning as well so I am going to switch back to the Flecanide. I was feeling really good that week I was off of the Ticosyn. The nerve pain dissipated over the span of the week I was off of it. I'll have to be off of the Ticosyn for three days before starting the Flecanide.

I'll probably wait three months before getting back on the speed machine (pinarello). I do plan to spend some time on the rails to trails with the family on the bikes I purchased for my son and I earlier this year in the interim. Bought a pair of gravel bikes. We had planned to ride the Allegheny passage and C & O Canal Trail from Pittsburgh to DC this summer. That's on next year's itinerary now. I was also looking at our Kayaks the other day and will probably hit the river on those next Saturday.

My son also mentioned yesterday that he wants to get back to the gym. So that is on the schedule as well. Slow and easy wins the race they say, Never been a believer personally but willing to give it a shot.

Learned a new term the other day while doing some research on exercising and how much might be too much. PAFIYAMA, Paroxysmal Atrial Fibrillation In Young And Middle-Aged Athletes. Whie I am down I am going to try to come up with a regiment that is palatable to both my psyche and my heart.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 31, 2018 08:57AM
Its been a few days since I posted. Figured the monotony of NSR was getting boring. But we all know that the time post ablation can be anything but boring sometimes.

The weekend started out the same nice calm NSR. DId some shopping in the afternoon followed by church. Then home to for a quiet evening. Sunday morning I awoke to find myself out of rhythm. This was the day I planned to start weaning myself off of the Ticosyn because the nerve pain has been creeping back. So I decided to wait until I had the opportunity to speak with my Afib nurse at TCA. Meanwhile I took some recordings throughout the day with the HEARTRAK (Kardia on its way).

I spoke with the nurse yesterday and what showed up on the strips did not concern them. Some affib and more elevated but normal rhythm which is totally normal for this stage (10 days). So she advised that I go ahead and stop the Ticosyn, which I did yesterday morning, so that I can go back to the Flecanide. She also said that I may have to up my dose of Metoprolol in the interim if I go out of rhythm again just to keep my rate down.

The other odd thing that happened was Monday morning very early. I had woken up around 3am still out of rhythm. I got out of bed to get a drink and came back to bed, At some point shortly after I converted back to what felt like sinus rhythm. However, my heart rate was very low. 37 bpm. It stayed this way for a while then jumped back to around 70. Then after a while back to 37. Now I was using a pulse oximeter to record these rates so the accuracy and interpretation of what was actually going on is up for debate.though the rate was steady with no fluctuation at both rates. I did run back out to the kitchen to grab the recorder to try and capture the event but what I was feeling and what was recorded were two different things. This continued for the entire morning; until my heart decided to just go completely haywire for the remainder of the afternoon into the evening. I converted back to NSR early evening and have remained there ever since.

This is the first time I have ever experienced such a low hear rate. My normal resting heart rate now is 62 bpm. And has been as low as 52 bpm when I was more active. One thing I think that may have contributed to this was that I had taken 75mg of Metoprolol the previous evening to try to keep my heart rate down as the 50mg I had taken in the morning was not enough. This is only speculation though. I had been taking 75 mg of Metoprolol with the Ticosyn prior to my ablation for the same reasons when the Ticosyn was not sustaining NSR without any issues.
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vanlith
Re: Ablation With Dr Natale This Friday 07/20/2018
July 31, 2018 09:31AM
Ya i think your right it's that heavy dose of met. that did but it should not jump around like you described thats weird......in the past i took bisoprolol a few times and it put my already pretty low fit heart that i have into a tailspin for beats meaning 40-45 which was crazy but unlike you it stayed there for about 12-16 hours then slowly returned.
It's only been 11 day's so try not to take anything too seriously....early to mid. sept. is the time to start doing that i say.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
July 31, 2018 09:57AM
Quote
vanlith
It's only been 11 day's so try not to take anything too seriously....early to mid. sept. is the time to start doing that i say.

I'm not worried. Taking it all in stride. The fact that I converted with only the one dose of Ticosyn, and have stayed there, says something. I think.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 01, 2018 02:04PM
Received my KARDIA today. I love gadgets. Took my first reading so I really have no information yet other than my heart rate wa 65bpm and it feels normal. I guess the first reading has to be looked at by a doctor or something like that so I'll wait. Then I can use it at will.

As to my current state I feel really good today except for the Sciatic nerve pain. We will see what happens in a few days after being off of the Ticosyn. Last time I stopped it, it took a few days before I started to feel better. I stopped the Ticosyn monday for my second dose so I wont start onto the Flecanide until Friday as those 2 drugs do not play well together. I upped my dose of Metoprolol to 50mg from 25mg for the next couple days until I get on the Flecanide. And of course I will remain on the Elequis indefinitely,

Like I said I feel really good today and as far as I can tell I have been in NSR since yesterday afternoon. I had some odd heart beats in the morning yesterday but that was it. I also received my ablation report yesterday. Its pretty detailed and informative. My wife, the nurse who I always felt would end up working in an EP or Cath lab, also thought it was good and commented on the details and all the other information within.

Shannon is going to call this weekend and go over it with us as well. So anything that is unclear to us will get sorted out. I'm also glad that my wife will finally get to talk to Shannon. She will have a much better understanding of everything Shannon says that sometimes shoots right over my head.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 02, 2018 09:56PM
Started back on the flecainide today. Heart has been quiet since yesterday. Had a brief run of flutter mid afternoon.

Had a busy day today. Took my son to the doctor, had a massage, went to drivers license center, then went to look at a convertible. Smoked some salmon and cod for supper. Life is good.
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vanlith
Re: Ablation With Dr Natale This Friday 07/20/2018
August 03, 2018 08:41AM
How long before you get off flec....i am thinking oct. at the latest when your blanking period ends.
Glad you are doing well but only when your off these hideous heart drugs esp. taken daily and still in nsr can you or anyone be really happy and say at least for the time being aaahhh success.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 06, 2018 12:26PM
Quote
vanlith
How long before you get off flec....i am thinking oct. at the latest when your blanking period ends..

This would be my guess as well'

My wife was looking at my strips from my Kardia and she said that the recordings I though were possibly affib were runs of PAC's and PVC's. SO that's a bonus.

I had a nice conversation with shannon yesterday. We went over my ablation report and my wife finally got to talk to him as well. This was the first time i have ever spoken to Shannon that remained in NSR the entire time and even afterwards. Milestones.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 09, 2018 09:07PM
Just a quick update. Heart has been pretty good only acting up occationally throwing a bunch of PAC's and PVC'S until Tuesday afternoon when I went out of rhythm for a few hours. It came back but then went out again Wednesday morning and has been out ever since. Im not sure exactly what's going on becasue it really does not look like afib or flutter but the rate is high. Dr. Natale contacted me this morning and wants me to have a cardioversion done ASAP. I called my EP in Pittsburgh and they are getting me in tomorrow morning @10am. Dr Voigt continues to impress me with his interest in my health.

I've also been dealing with some severe sciatic nerve pain again and have not been sleeping very well since returing from Austin. I originally thought that it was the ticosyn causing this as when I went off of it the week leading up to my ablation the pain subsided. Then after the ablation and going back on the Ticosyn the pain started creaping back.The pain has been increasing almost daily since my return and reached its crescendo a week ago. Even though I stopped the Ticosyn and went back onto Flecanide. I've only been getting abuot 4 hours of sleep a night which I am sure, coupled with the waves of pain, is contributing to my heart not behaving.
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jpeters
Re: Ablation With Dr Natale This Friday 07/20/2018
August 10, 2018 01:27AM
Best wishes for your cardioversion tomorrow. Dr Voigt looks like a great guy, and I'm sure you'll be well taken care of. Hang in there!!!
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 10, 2018 01:39AM
Quote
jpeters
Best wishes for your cardioversion tomorrow. Dr Voigt looks like a great guy, and I'm sure you'll be well taken care of. Hang in there!!!

Thanks Jpeters. Im hanging tough and staying positive.

Dr. Voigt is exceptional. He actually called and talked to me this afternoon.to discuss my ablation with Dr. Natale as well as tomorrows festivities with me.

As usual the part I am dreading for the morning is the TEE. As I am sure you have read in my previous posts I have only had 1 out of 3 good expereinces at UPMC with a TEE. My newly retired Cardiologist performing the 2 bad ones. So I am interested to see how tomorrow goes.



Edited 1 time(s). Last edit at 08/10/2018 01:41AM by rocketritch.
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jpeters
Re: Ablation With Dr Natale This Friday 07/20/2018
August 10, 2018 01:56AM
I had a TEE on July 19th, right before an ablation in San Francisco. So I'm on the table, and we're all waiting for this cardio to arrive so we can get on with it. He arrives about 45 minutes late all stressed out, and first thing he does is try to convince me that I'll never pass it. It's a strange world!



Edited 1 time(s). Last edit at 08/10/2018 01:58AM by jpeters.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 10, 2018 08:07PM
Cardioversion went well. Was in flutter.

Met a new cardiologist as well today. My TEE experience was as it should be as well. Uneventful. Didn't even know I had one done.

Dr.Voigt was top notch as usual. He went over my ablation report from Dr Natale with me and we discussed how things went in Austin.
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jpeters
Re: Ablation With Dr Natale This Friday 07/20/2018
August 11, 2018 12:33AM
Quote
rocketritch
Cardioversion went well. Was in flutter.

Great!! Welcome back.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 11, 2018 08:13AM
Quote
jpeters
Great!! Welcome back.[/quote

Thanks!! I had been having some of runs af PAC’s and PVC’s this week and was wondering if one of those runs may throw me into afib or flutter.

Yesterday was exactly 3 weeks since my ablation so I’m not the least bit concerned. The folks in the EP Lab said not to take it the wrong way, but they didn’t want to see me again. 😁
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jpeters
Re: Ablation With Dr Natale This Friday 07/20/2018
August 11, 2018 09:49AM
Quote
rocketritch


Thanks!! I had been having some of runs af PAC’s and PVC’s this week and was wondering if one of those runs may throw me into afib or flutter.

Yesterday was exactly 3 weeks since my ablation so I’m not the least bit concerned. The folks in the EP Lab said not to take it the wrong way, but they didn’t want to see me again. 😁

I got some of those yesterday (connected with my ablation on July 19ty). Thought it might be afib, but after sending in a report was told it was just some normal flutter. I took some diltiazem to bring down the pulse rate, and they scheduled a cardioversion for Monday in case it didn't resolve on it's own. I'm not feeling much in the way of symptoms. It's interesting that if the pulse goes up, systologic pressure goes down to compensate.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 11, 2018 10:24AM
Quote
jpeters
I got some of those yesterday (connected with my ablation on July 19ty). Thought it might be afib, but after sending in a report was told it was just some normal flutter. I'm not feeling much in the way of symptoms. It's interesting that if the pulse goes up, systologic pressure goes down to compensate.

I notice them when they happen. I’m very symptomatic. Interestingly I did not notice the flutter as much other than being amped up. My rate was 115. I have Kardia recordings but was unable to personally identify what I was seeing because it didn’t look like flutter or afib to me or my wife the nurse. They even held off at the hospital putting in my IV until my EP verified I actually needed a cardio version.
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jpeters
Re: Ablation With Dr Natale This Friday 07/20/2018
August 14, 2018 02:08AM
Quote
rocketritch

They even held off at the hospital putting in my IV until my EP verified I actually needed a cardio version.

Dr. Hongo showed up for mine, taking charge of the entire procedure (getting the pads in the best position, etc). Main advice was not to exacerbate inflammation with too much exercise during the blanking period, and keeping the pulse rate down with diltiazem for the near term. I couldn't be more pleased with my choice EP's.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 14, 2018 10:27AM
Quote
jpeters
Main advice was not to exacerbate inflammation with too much exercise during the blanking period, and keeping the pulse rate down with diltiazem for the near term. I couldn't be more pleased with my choice EP's.

I haven't done much of anything since my ablation. My sciatic nerve pain has kept me pretty sedentary since July 20; Taking 50 mg metoprolol and 100 mg Flecanide twice a day and of course the elequis. Also taking K and Mag to keep those levels where they should be. My doctor usually tests me for Magnesium levels when he is running tests but didnt this time.My potassium was 4.3 though on Friday and my mag historically runs around 2. I'm also on a couple things for the sciatic pain as well.My resting heart rate is between 56 and 62 and my BP at the doctors office yesterday was 100/60 so I'm pretty docile on the heart front right now.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 17, 2018 08:48AM
Its been a week since my cardioversion and 4 weeks since my ablation with Dr. Natale.

Heart has been in steady rhythm since friday. No PAC's or PVC's that I have noticed. Heart rates have been ranging between 54-62 bpm. My BP was 100/60 the other day at the doctors office. I'm feeling really good, except for the sciatica which is unrealated and at times unbearable.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 19, 2018 09:06PM
Everything still good on the heart front. Nice steady beat.

I also finaly got some definitive answeres as to what is going on with my back. I ended back up in the ER on Saturday unable to walk. I had called my PCP on Friday and he fianlly wrote me a script for an MRI but th nuirse was having a heck of a time getting preauthorization. I have good insurance but its based out of Texas. In Texas, even though the insurance provider requires no preauthorization fo an MRI, I would still have to go through a third party aproval. Fortunatly I dont live in Texas, so I dont have to go through that procees. Of course it took the nurse at my Doc's office talking to someone and me talking to two more to find that out. So I scheduled an MRI at the local Hospital to be done on Wednesday.

I woke up Saturday morning with another terrible flareup. I hobbled to the living room and imediately started calling around to see if I could get an MRI done that day. There were several places open but none could fit me in. My wife came home a short while after and we started to talk about my current situation. No MRI until Wenesday. Then another day or two before my Doctor got the results which put me into Friday at best. Then to find a specialist and make an appointment need be. Then who knowas what. The steroids and pain meds are doing nothing for me The pain I have been experiencing is unlike none I have before. It has even surpassed the kidney stone pain I have experienced as well as any bodilly trauma I have expeinced crashing Road bikes on pavement and mountain bikes in rock gardens. So after some prodding my wife and son helped load me up into the truck and we were off to the same ER I was just at the week prior. This is where they did xray's and CTA scanns to rule out any clots in my leg..

I really lucked out in the ER on Saturday though. It was like a ghost town so I went straight to a room. Then I lucked out as the ER doc had back issues as well so he was pretty sympathetic to my current situation. I was unaware of this at first though.After he had asked me some basic questions he said he wanted to tell me something, but not to say anything until he was done. He started off by saying that, like every other doctor, he believes that my back pain is in my head. He then paused for a second and I told him that he was entitled to his opinion. He then proceeded to open his coat to reveal a back brace. He has had a long history of back pain and has had a couple surgeries himself.

So I was lucky and I had my MRI done shortly after speaking to him. So now I know that I have a herniated disc, between L4 & L5. Not the news I wanted to hear but at least I know what is going on and can address the issue. He also contacted one of the pemie back specialist in teh area and he said he would see me this week. All, I have to do is call monday morning to set up an appointment. I am also going to contact a diffeent Chiropractor tomorrow to see if I can get the releif I need that way.
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Sam
Re: Ablation With Dr Natale This Friday 07/20/2018
August 20, 2018 06:24AM
I'm a retired Physiotherapist and Manipulative Therapist. I also studied the Osteopathic,Chiropractic, Maitland and Bowen techniques. Discs have a tough fibrous outer with a jelly like interior. When the outer ring splits the jelly like interior bulges out and presses on a major nerve. I've suffered from it myself in the past and described the pain as molten lead being poured down the inside of my leg. Absolutely excruciating.

I treated many people with this condition with, as far as I can remember, 100% success rate. I found the high velocity techniques of Osteopaths and Chiropractors too severe and always used the gentler mobilizing moves of the Maitland technique. I then gave the patients mobilizing exercises to do twice a day.

Try to find a practitioner who uses these techniques and please think very carefully before resorting to surgery. The fact that your Doctor had a couple of surgeries and still had to wear a back brace tells you all you need to know.

A little tip. If you have to cough or sneeze don't bend your head forward; keep it upright.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 20, 2018 06:33AM
It was the er doc that had surgery. It's been my observation that back surgery is no good. I know 5 people that have has surgery and only one had marginal success.

Surgery is an absolute last resort in my mind. I'm going to try to get into a different chiropractor today. I've been reading about a new treatment that has actually helped a guy a know of. And this guy does it. It's a gental decompression type of therapy.

I have to do something. The pain pills don't even touch it. And my walk into work is almost unbearable at this point.



Edited 1 time(s). Last edit at 08/20/2018 06:36AM by rocketritch.
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Jackie
Re: Ablation With Dr Natale This Friday 07/20/2018
August 20, 2018 09:18AM
rocketrich - if you can locate a practitioner in your area who is trained Directional Non-Force Technique,
(DNFTTM) -- try that. It's a form of chiropractic involving 'spinal alignment' that doesn't involve the typical twisting or cracking maneuvers. Very gentle and totally different from what you'd expect from chiropractic.

The results are amazing and offer almost immediate relief from a variety of pain areas including back.
I use it and know many others who also have found relief. You can also consider Prolotherapy - just be sure
you do good research on the qualifications and experience of the practitioner. We have several experts in our area and those having that treatment are very happy with the results for back disc pain and joint pain.

Sorry you are struggling. Severe back pain is horrific.

Jackie
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 25, 2018 01:01PM
Its been 5 weeks post ablation with Dr Natale. My heart continues to behave since the Cardioversion. I have felt zero PAC's, PVC's, Eptopics or any other anomoly since that day (KOW). Of course the back pain is still there from the herniated disc. I hope to be able to address that this week.

What frustrates me most about the back pain is that it is puting undue stress on me and my heart during this critical time of healing. And for whatever reason, I am to be unable to clearly comunicate that to anyone that could possibly help me. Very frustrating. I actually thought that I was getting somewhere yesterday, but since I am still sitting here in pain it is blaintently obvious that it was just a ruse. So now to wait til Monday to double down on my efforts.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
August 26, 2018 09:01PM
Had a rough day today. What I had been fearing would happen with all the pain actually happened this morning. I went out of rhythm while hobbling into work.

Yes it's that bad. I converted back this evening so all is good for now. Tomorrow starts the third and what I hope is the final round of me getting a nerve block.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
September 02, 2018 02:12PM
Well its been a rough week.

Went back out of rhytm following my last post and have ben their ever since. My sciatic nerve pain continues to be unbearable.I went for my nerve block last Friday and it did relieve the pain somewhat. I also got clareification that I have somehow managed not one but two bulged discs. A right paracentral bulge at the T12-L1 and a far lateral disc herniation right side at the L5-S1. So I'm not sure where this is headed but I have a pretty good idea. Having an EMG done Tuesday to test for nerve damage which will further guide any dicisions.

Needless to say I'm not in the greatest of spirits these days but know that both issues will get sorted out. And I'll be back to normal and put this all behind me.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
September 06, 2018 12:18PM
Talked to Dr Natale's office today. They are going to contact my local EP today to have another cardioversion done. They are wanting me to remain on the flecainide though so we will see.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
September 06, 2018 08:21PM
Current situation.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
September 14, 2018 12:49PM
Second cardiversion since my July ablation is sceduled for next Thursday. I wish they could have gotten me in sooner but that was the best that they could do. So now I wait. I'm a little frustrated but I knew going in that there would be the possibility of another procedure so I'll continue to go with the flow.

On the positive side of things my back pain is allot better these days and will hopfully continue in that direction.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
September 17, 2018 02:28AM
Back in wonderful NSR. Not sure when it happened because I feel like crap.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
September 17, 2018 06:01PM
Quote
mwcf
rocketritch,

Glad you're back in NSR.

If you don't mind me asking, what was Dr Natale's findings and verdict on the procedure he did for you this last July?

During my ablation, and following induced affib my heart was calm. After doing some work on the LAA he moved to the coronary sinus. This is when my affib organized organically starting at the LAA. After working on the coronary sinus he did go back and do some more work on the LAA.

When we spoke the following day we talked about the LAA and the Watchman device. He said that the watchman for me would not be an option right now. First and foremost reason being that there would be a possbility of having to go back and do more work on the LAA. The second would be at my age, insurance would not want to pay to have a watchman inplanted.

That all being said, I am satisfied with the work that Dr. Natale did as well as the work Dr Voigt did back in 2009. In reality I have only had 2 ablations. I discount the one in January as it was basically just a redo of what I had done back in 2009. Had Dr. natale done my second ablation the outcomes could have been totally different. So far as events following my ablation in July the first cardioversion could be in part due to me taking days off of meds to change anti-arrhythmics. And my most recent run of arrhythmia was due to the pain I was enduring with the sciatica.

I am still within the 3 month blanking period at this time, and I did convert back to NSR after being out of rhythm for about 2 weeks. So I do still hold some hope that things will continue to get better knowing that another trip to Austin is a possibility.



Edited 1 time(s). Last edit at 09/18/2018 07:47PM by rocketritch.
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mwcf
Re: Ablation With Dr Natale This Friday 07/20/2018
September 18, 2018 06:40AM
Thanks rocketritch.

Fingers crossed that things smooth out after the blanking period for us both!
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
September 21, 2018 09:14AM
Quote
mwcf
Thanks rocketritch.

Fingers crossed that things smooth out after the blanking period for us both!

Agreed.

I have been in NSR all this week. The previous two weeks were pure hell. Between being out of rhythm, sciatica and averaging 3-4 hours of sleep a night I felt like a ticking time bomb. Couple that with being off the eleqiuis for the three days leading up to my nerve block while being out of rhythm.

But this has been a new week and I still haven’t lost sight of my goal to rid myself of this issue. I also haven’t lost hope that things will continue to progress in a positive manner as my pain is dissipating and my heart is in rhythm.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
September 29, 2018 10:13PM
Another week of wonderful NSR. Also a short weekend trip to the shore with the family. Life is good.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
October 02, 2018 11:46AM
Nothing new to report. Had a nice conversation with Sharon yesterday afternoon. Took a short trip to the shore over the weekend and committed to purchasing a 65 falcon Futura as well.

Life is good.
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MissSunshine
Re: Ablation With Dr Natale This Friday 07/20/2018
October 09, 2018 12:20PM
Rocketritch - I’m just wondering how you are doing? Hope that your heart is behaving itself? Any PACs or PVCs?
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
October 09, 2018 09:45PM
Quote
MissSunshine
Rocketritch - I’m just wondering how you are doing? Hope that your heart is behaving itself? Any PACs or PVCs?

Doing well thanks for asking.

If you read back over my posts or check my blog you'll see I've had quite the time of it.

I had some runs over PAC's and PVC's early on but absolutely nothing for the past 3 week but wonderful NSR.

I'm quickly approaching my 3 month point. It's gone so fast. I have an appointment with my local EP at the end of the month and after that I should be talking with the good folks in Texas to discuss the next steps.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
October 12, 2018 11:11AM
A very busy wek behind me. Drove back to the shore to purchase a 65 Falcon Futura after coming off of night shift. Had a wonderful dinner with the family while we were there at a marina along deep creek Maryland. Made for a long day driving but had good company. Couple that with a 3 day work week.

My heart is still behaving itself and my back continues to improve. Life is very good.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
October 22, 2018 07:01AM
3 month anniversary was Saturday. Dr Natale's office contacted me on Thursday and he wants me to stop the flecanide.

They said I could just stop it but I'm going to do a short taper and be off it by Friday. I'm down from 200 mg/day to 100 mg/day as of today.

There is always a little apprehension when quitting these drugs due to the possibility of things not going as well as you miyhave hoped. Worse case cenario is that my heart does not stay in nsr and I have to make another trip to Austin for another procedure. Which in the grand scheme of things is not a big deal.

If all goes well I will get a 7 day monitor in January and if that goes well will fly to Austin for a TEE to check the function of my LAA.
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MissSunshine
Re: Ablation With Dr Natale This Friday 07/20/2018
October 22, 2018 08:39AM
That is all great news. I hope that another ablation is not in your future. But, as one who has had a second ablation at Texas Cardiac Arrythmia, that is the last thing to worry about. Here’s to NSR for decades to come!
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
October 27, 2018 12:38PM
Took my last 25mg of Flecanide yesterday morning. Feels really good to be sitting here in NSR without it. Now the waiting game commences. Hopefully it won't be long and I will be off of the Metoprolol.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
October 31, 2018 07:43PM
So far so good on both the heart and spinal front. Been doing allot of work around the house and garage making room for the new ride.

Had the opporatunity to get out and do a little cycling today between sleeping late getting ready for night shift and physical therapy. Did 6 miles and tried to keep my heart rate below 110 which is practically impossible around hear due to all the hills. The highest my heart rate got during the ride was 124bpm. It's amazing how your fitness deteriorates over the period of 10 months.

Bad wether is looming now so I need to get the indoor trainer and computer set up and start ZWIFTING.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
November 12, 2018 09:13PM
Starting week three without the flecanide. I have been feeling the occational little blip in my chest but nothing major. I'm not convinced at tis point that its not just gas or ocational musce spasm. I take the steps at a pretty brisk pace every day at work, and other than the effects I normally feel from the metoprolol, I feel fine.

I have always been able to feel any little flutter or missed beat but just like back in 2009 my senses seem to be extra sensitive to whats going on an its probably nothing at all. The time lines for both prceedures are pretty similar being that my afib/flutter had become basically persistant.
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MissSunshine
Re: Ablation With Dr Natale This Friday 07/20/2018
November 12, 2018 09:20PM
Rocketritch - so glad that everything is going well! I hear you when you say you can feel every skipped beat. I think we afibbers are hyper sensitive to every beat of our hearts. Carry on and live your best life! I hope to be following you into decades of NSR! I had my second ablation in Austin on June 5th. I had a 20 minute tachycardia episode in mid-September but have been quiet since. Even though it was outside of the blanking period, I hope it was still healing. I wish you all the best! Please keep us posted as to how everything is going and when/if you get off your anticoagulant. There is much to be thankful for this Thanksgiving!
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
November 13, 2018 08:03PM
Quote
MissSunshine
Rocketritch - so glad that everything is going well! I hear you when you say you can feel every skipped beat. I think we afibbers are hyper sensitive to every beat of our hearts. Carry on and live your best life! I hope to be following you into decades of NSR! I had my second ablation in Austin on June 5th. I had a 20 minute tachycardia episode in mid-September but have been quiet since. Even though it was outside of the blanking period, I hope it was still healing. I wish you all the best! Please keep us posted as to how everything is going and when/if you get off your anticoagulant. There is much to be thankful for this Thanksgiving!

I have always been symptomatic with my affib. It baffles my mind that there are those that don't even realize they are out of rhythm.

You are right in the fact that there is much to be Thankful for this Thanksgiving. Between my heart and back issues this year, and having had everything improve so drastically, I am indeed thankful. I am also thankful for the wonderful people I have become associated with through this website. I cant put into words the gratitude that I have for Shannon and his assistance helping me get locked into Dr Natale and his staff.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
November 20, 2018 12:26PM
Was finally able to capture a recording of my odd heartbeats this morning. As usual, it happened when I was really not doing much. I had only been out of bed for about 15 min and was packing my lunch. I just happened to have my phone and KARDIA laying there. I captured several recordings. The first looked to be a run of eptopics with a HR of 154 bpm. The second was sinus rhythm with an elevated HR of 88 bpm. The third was another sinus with several PAC's thrown in with a HR of 84. And a fourth recording of sinus rhythm with a HR of 90 bpm. These were all taken within minutes of each other with the first event only lasting about a minute as I went back to pure sinus rhythm within about 15 seconds of the 30 second recording.

I took another recording after I arrived at work. which included a 1/4 mile walk including 4 flights of stairs that would equal around 8 normal flights of stairs in your home. It took me around 4 minutes to get situated before I could take a reading but the reading ws NSR with a HR of 74 BPM.

I emailed everything to my afib nurse and she responded informing me not to worry that everything looked ok and not to worry. i told here I've been in this game far to long to worry. SO its business as usual for now.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
December 01, 2018 04:01AM
Just finished up a nice little walk on the treadmill at work.The heart continues to hum right along and the eptopics seem to have diminished This may be in part due to my steady intake of MG and K.

Going to try and spend a couple hours in the woods in the morning looking for Bambi's dad. If nothing else maybe catch a woods nap as I have one more night shift to do.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
January 02, 2019 08:12AM
Happy New Year. Everything is still going well. An occasional eptopic but nothing really notable. I should be receiving a 24/7 monitor some time this month based on conversations with my afib nurse then a trip to Austin possibly in February for a TEE to see if I can stop the Eliquis.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
January 15, 2019 12:54PM
Still continuing to progress.Getting into the Gym 3X a week and doing a good bit of walking both on the treadmill and around the plant at work. I haven't had a chance to get on the bike though do to weather. The indoor trainer hasn't gotten any use either due to my backlog of household projects that didn't get done this past year.

If we get the snow they are calling for maybe I will get out and do some XC skiing this weekend.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
January 24, 2019 12:43AM
Was contacted by Dr. Natale's office yesterday. They are sending a 7 day monitor for me to wear. If all goes well I should be heading back to Austin for a TEE so that I can hopefully get off of the Elequis.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
January 29, 2019 12:11PM
Talked with Dr Natalea office yesterday concerning the time frame for me remaining on the metoprolol. They said that that decision would be made after the 7 day monitoring period.

I received the Zio Patch today so we will see how things go. The patch is interesting. All monitors I have had in the past were 3 lead type. This just sticks to my chest.

So far as the metoprolol goes I am down to 25mg a day which is what I was originally prescribed anyway. I was only taking more due to being out of rhythm all the time.



Edited 1 time(s). Last edit at 02/01/2019 04:32PM by rocketritch.
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Kleinkp
Re: Ablation With Dr Natale This Friday 07/20/2018
January 31, 2019 11:15PM
Thanks for all the updates it's a real look inside the recovery process. I'm in line for procedure from Dr Natale. Waiting to hear back from his scheduler Amy hoping any day nowwinking smiley.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
February 10, 2019 07:48AM
Sent the ZIO patch back the other day. Now to wait and hear of the results and the next step.
My Blog



Edited 1 time(s). Last edit at 02/10/2019 08:09AM by rocketritch.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
February 15, 2019 08:22AM
Woke up out of rhythm this morning. Have been under allot of stress since last Friday.



I got out of bed shortly after taking this ecg and hit the deck. I didn't go out completely I just sort of crumbled.

I took my normal meds afterwards, elequis and upping my metoprolol to 50mg. I took a flecanide about a half hour ago and I've since converted back to sinus rhythm. I sent an ecg to my afib nurse and will be contacting Dr Natale's office later.



Edited 5 time(s). Last edit at 02/15/2019 01:26PM by rocketritch.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
February 15, 2019 01:28PM
Had contact with my afib nurse. They downloaded the info from my 7 day monitor and it showed several short runs of what I had today. Dr Natale will be in the office next week and will go over everything then. Until then business as usual.
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MissSunshine
Re: Ablation With Dr Natale This Friday 07/20/2018
February 15, 2019 01:53PM
Good afternoon Rich - I am so sorry to hear about this. I am sure that it is disheartening, to say the least. How long were you out of NSR? It sounds like the flecainide quickly converted you. We all wish that our hearts did not have a mind of their own but a new normal may be that the PIP quickly gets us back into NSR. I am hoping that it is just a small blip on the road to a long full life with your heart behaving!! I have been following you since I came on this forum almost a year ago. I had my first ablation at TCAI a year ago and my second in May. The last episode, other than PACs and PVCs was in September of 2018. I wore the Zio a few weeks ago and am scheduled for a TEE the end of the month. I do believe it is all a process with setbacks, here and there. Live your life to the fullest extent possible. If the beast comes back, then you deal with it. But, today, now, you are in NSR. I know that is easier said than done. Please keep us posted as to what Natale and your healthcare providers say. Hang in there. We are all pulling for you!
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
February 21, 2019 04:16PM
Thanks MS. I'm not the least bit disheartened and carrying on with life normal as I've been in this game a long time. I again spoke with my afib nurse and she said I had 17 short episodes recorded on the ZIO the longest of which was 17 beats. Nothing sustained. The only sustained event is the one that I recorded on my Kardia device which isn't really any help when it comes to diagnosing.

The current plan is to wait 3 months then do another ZIO patch. If all is ok between now and then and nothing shows up on the patch they will schedule me for a TEE. to check LAA function. In the interim,what will be truly helpful, if this trend persists, is if I can capture an event on a 12 lead ecg which may be tricky. I have contacted a local urgicare place to see if they have one and they do. However, the process to getting one done when I am out of rhythm is going to take time and my fear is I will convert before they get to record then I'm out $$$ with nothing to show for it. I still need to contact my local Fire Dept to see if they have one. I also need to contact the local ambulance service. I used one of those many years ago to capture an event.

I have also had a couple phone chats with shannon over the past week so lots of of good advice there and ideas as well.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
March 20, 2019 10:30PM
Not much new to report here. Haven't had any more sustained arrhythmia's. I have had a few eptopics and such but that is it. I did about 80 miles on the bike last week over 3 days and continue to go to the gym 3 days a week. I also got some work done on the convertible as well. Life is good.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
April 01, 2019 07:52PM
was at the gym this afternoon and went out of rhythm again. Gathered up my son and headed to the local ambulance service. They have 2 centers in town and I just happened on the one that only schedules transportation. After spending a few minutes trying to tell them that I didn't need an ER just a 12 lead EKG they said I should try their other office.

So back to the truck and across town the their other facility. I walk in and they are having a paramedic class. One of the instructors came out into the hall and I again start explaining my needs. Their first response was to ask if I wanted to go to the hospital. After a few minutes of explaining that all I needed was a 12 lead EKG before I convert back to NSR. That I did not need a hospital that was going to charge me $1000, maybe or maybe not get to me before I converted, then try to admit me the finally got the comfort level that I was aware of what I was doing.

They took me over to the Paramedic side of the building and they briefly explained my situation and what I needed and the manager grabbed their Portable EKG and lead me to their lounge. They hooked me up and got a recording. I thanked them and made my way back to the truck and converted back to NSR without meds, so I was out of rhytm for about 30 minutes same as last time There was allot of other conversation and banter in between, mostly them trying to tell me I should go to ER. They were also confused why the doctor would not want me to go to the ER

Here is what I got.







Edited 3 time(s). Last edit at 04/01/2019 08:05PM by rocketritch.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
April 02, 2019 08:52PM
Heard back from my Afib nurse. She is handing this of to Dr. Natale's Nurse practitioner and I should be hearing from her soon. My guess is I wont be returning to Austin for a TEE anytime soon. More than likely I will be returning for a touch-up which is fine by me.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
April 13, 2019 05:56AM
Dr Natale's scheduler sent me a date for May 23. I talked it over with his NP and we came to the conclusion that I would pass on that and shoot for something further down the road.

I've had 2 break through's since last September which isn't that much. I've also done a couple hundred miles on the bike with no issues thus far. I haven't really been pushing myself but having been off of the bike for so long I'm a bit out of shape. So even JRA (Just riding around) pushes my heart rate up especially on the hills. I've seen max hrm's thus far @154 bpm with good steady recovery times.

The second break through was proceeded by a short run of PAC's. Teh first I am unaware as it woke me from a deep sleep. I'm wondering if the break through's had more to do with mineral imbalance. When I'm riding I'm more regimented in keeping up with my Mg & K.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
April 18, 2019 07:18PM
Had another break through event on Sunday. I took a call out at work so didn't get any sleep. At the 18 hour mark I went out of rhythm. I ended up taking a Flecanide as I was concerned that since I had so little sleep, and had 4 more hours to go, I may not convert as quickly. I was out of rhythm for 1 hour. So that makes 3 events this year, Feb 15, April 1 and April 14. Two of them happened wile relaxed and the other at the gym. Non of these happened under any conditions I am used to. My events were always just after or during sustained cardio exercise

I talked to Dr. Natale's scheduler the other day. He hasn't released any dates for June or July yet so now it is just a waiting game. I continue to exercise without issue to this point. Did 34 miles of dual surface cycling yesterday without any issues.It feels so good to be back to doing normal things again. even with the current arrhythmia issues lingering in the background. One tihng for sure whatever work Dr. Natale did is doing its job and now its is just a matter of completing the isolation of the LAA.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
April 24, 2019 05:51AM
Not much happening these days. Been working on the convertible and riding my bike. Did just over 80 miles over the past 2 days with zero issues. Even did a 2 mile walk with the family later both days. It appears, at least at this point. If I am going to have an event its going to happen when I'm just sitting around doing nothing. Even the event I had at the gym that day I wasn't pushing myself.

I'm starting to wonder if I am rushing into the touch up ablation now. I know that the afib will most likely continue to progress and know that nipping it in the bud right now is the best plan of attack. But I also wonder if the couple events I had stem more from a lack of minerals. When I am riding I know I use up allot of minerals so I am careful to maintain my hydration and mineral intake. When I'm not riding I can tend to get a little lax in mineral maintenance.

[www.strava.com]
[www.strava.com]
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
April 24, 2019 09:09PM
I guess I spoke too soon. Had a break through event tonight. Was in the basement truing up a wheel and replacing a broken spoke. Walked up the steps and across the kitchen then boom.

Not sure of the arrhythmia. Rate of 160 bpm. Looked normal for the most part though except for some pac's and pvc's. I converted back to NSR in a little under 15 minutes. I did take a flecanide but that wasn't nearly long enough to take affect.

This does play into my thoughts that it could be deminished minerals. I hydrated good the past couple days and was taking my K and Mg but probably not enough. Two forty mile days in a rowand one being near 80 deg. I definitely taxed the system.

It's either that or I'm going to go out of rhythm around every 10-14 days or so since that is he pattern for the month of April so far. Ugh.
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MissSunshine
Re: Ablation With Dr Natale This Friday 07/20/2018
April 24, 2019 09:20PM
Rocketritch - sorry to hear about this. Do you think there has been some reconnectivity or are there arrhythmias coming from your LAA? If you go for another ablation, are you thinking about closing the LAA and a watchman? Good news is that you are converting in minutes vs days. I am sure you are weighing all your option. I was just in Austin on Monday for a TEE ( I had one earlier by my local cardiologist but he did not get the information and measurements needed to make a decision to stop Xarelto). Good news for me is that I was able to stop Xarelto. Hang in there. TCAI and Natale’s team is the best. You are in good hands.
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rocketritch
Re: Ablation With Dr Natale This Friday 07/20/2018
April 24, 2019 09:59PM
LAA was where my organic episode originated during my ablation last July. Dr Natle did so some work there but when we talked afterwards he didn't rull out having to go back and do more work.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
May 04, 2019 10:43PM
Had my longest breakthrough event this evening after returning home from work. Just hanging out in the kitchen helping my wife make macaroni salad when I went out of rhythm. The rate reached a little over two hundred for a portion of the event.
I took 200 mg of flecainide and 75 mg metoprolol and converted 3 hours later
There's been a fair amount of stress around here lately so I'm sure that was a contributor to the event.
I also had a colonoscopy this week so the stress coupled with the prep and dehydration associated with that surely played a major factor



Edited 1 time(s). Last edit at 05/04/2019 10:47PM by rocketritch.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
May 07, 2019 10:27AM
Scheduled a followup ablation with Dr Natale for this July 18.
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ln108
Re: My Ablation With Dr Natale (07/20/2018)
May 07, 2019 04:28PM
Sounds like a good move. Thanks for the update!

--Lance
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
May 13, 2019 10:18AM
This 10 day cycle of arrhythmia is making me nuts. Went out again this morning at the gym.

I think my breathing was off when I was doing my last excercise which is when it started. Episode lasted 1 hour.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
May 15, 2019 11:01AM
Well yesterday was a sad day. I had to say goodbye to my local EP of 10 years. Not by either of our doing but due to insurance.

You see locally we have one of the best hospital networks there is with University Of Pittsburgh Medical Center (UPMC). We also have another great system) which is Allegheny Health Network (Highmark).

Unfortunately for patients in this area these two conglomerates can't get along. So if you don't carry their specific insurance they won't accept you as a patient. So people all over the area are saying goodbye to their caregivers that they have grown to trust over the years.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
May 27, 2019 09:01PM
The date is set for July 18th and airline tickets purchased. Need to make reservations this week. Think I am going to give the Days Inn across from St. Davids a try this time.

My wife and son will be joining me this go around so hope to see some sites this time around. Will get there early Tuesday morning. Consult and whatever testing needs to be done on Wednesday. Ablation on Thursday then released on Friday. Based on previous ablations I hope to be able to get around some on Saturday. Would like to go see the Alamo. Flight back to Pittsburgh Sunday afternoon.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
June 02, 2019 01:26PM
Not much happening lately. I have been feeling a little off since yesterday evening. Had a good 30 mile outing on the bike Friday after being off of it for almost a month due to monsoon season, work and life in general. My effort was more than usual, according to my fancy bike computer anyway. I was a bit hypoxic at the end of the ride but nothing more than that. Then last night I had some severe stomach cramping after dinner but that was it. I was feeling better later in the evening until I had a couple tablespoons of honey. Then I really felt bad. Kind of a combination of a sugar high and nausea. So I cut the evening short and headed off to bed.

Still not right today either but better. I have felt a couple eptopic beats over the past 24 hours as well.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
June 10, 2019 11:55PM
Nothing new to report. My ❤️ has been behaving itself as of late which is a good thing.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
June 13, 2019 08:20AM
Spoke to soon. Was awoken last night by palpitations which lead to being out of rhythm.
I had spent the day working in the hot sun then topped the day off with a trip to the local Chinese buffet. I also have neglected my magnesium and potassium supliments the past several days.
Dehydration, high ammount of MSG and lack of supliments. A perfect storm.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
June 13, 2019 11:28PM
Really wiped out today. I'm not sure if it's due to the flecainide I took to convert or having been out of rhythm.
I've never had I'll effects from flecainide in the past but then again when I was in it it was for extended periods of time. Also when I was just using it as a PIP I was in much better cardiovascular shape than I am currently.
Really looking forward to seeing Dr Natale in July to get this eliminated.
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MissSunshine
Re: My Ablation With Dr Natale (07/20/2018)
June 14, 2019 12:01AM
I’m so glad that you are soon going back to TCAI and having a third ablation from Dr. Natale. One more month!!! Best wishes and please keep us posted as to your ablation and recovery.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
June 15, 2019 11:48PM
Thanks for the well wishes MS. I'm so thankful for Dr Natale and the members of this board.
Looking back to this same time last year I am so much better off there is no comparison.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
June 29, 2019 03:09PM
Nothing of significance heart-wise lately. I did have a short run of eptopics last week that I thought was going to lead to afib but they stopped.
Only a couple weeks and I'll be back in Austin.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
July 02, 2019 05:44AM
Had another run of eptopics last night that lead to afib. Thought it might be flutter at first but the Kardia caught possible afib on the third reading with a rate of 178.

Took a couple flecanide and went to bed. Woke up in 52 bpm NSR this morning but completely wiped out as usual. July 18 cant get here fast enough.



Edited 1 time(s). Last edit at 07/02/2019 08:44AM by rocketritch.
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MissSunshine
Re: My Ablation With Dr Natale (07/20/2018)
July 02, 2019 08:24AM
Hang in there. This will all be a distant memory. Enjoy Austin and, as you know, you are in great hands - both Natalie and St. David’s staff. Keep us posted.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
July 10, 2019 10:08PM
This time next week I will be back in Austin.
I will arrive early Tuesday. Will meet wit Dr. Natale Wednesday and Have surgery Thursday. I'm excited to get there and get it done.My wife as usual is still a little apprehensive but excited for me as well knowing how miserable the afib makes me feel. It has also kept me from doing many of the things I enjoy.
Since my last episode a few weeks ago I decided to hang the bicycle up for the time being. To this point I have had zero issues on the bike but that doesn't mean that I wont. It does appear though that I can expect to have some sort of event in the days following a ride. The events also seam to be more pronounced than they were earlier this year. And afterwards I am completely wiped out for at least a day.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
July 17, 2019 05:43PM
Met with Dr Natale this morning. Spending the day roaming around the city. Lots of great sites and the people are fabulous.
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ln108
Re: My Ablation With Dr Natale (07/20/2018)
July 17, 2019 11:05PM
All the best to you on Thursday. Keep us posted!

--Lance
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
July 18, 2019 07:33PM
Quote
ln108
All the best to you on Thursday. Keep us posted!

Thanks Lance,

I was #1 this morning. Saw Dr. Natale stepping into a patients room as they were wheeling me to the EP Lab.

He just popped in to say hello on his way out this evening. He was very pleased with how things went and I didn't want to hold him up with a bunch of questions after such a long day as he will be back in the morning. I know his focal point was the LAA as thet is what we discussed yesterday.

I'll post more tommorow.

Rich



Edited 1 time(s). Last edit at 07/19/2019 02:15PM by rocketritch.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
July 19, 2019 02:15PM
Back at the hotel after a fairly restful night.

Yesterday was a long day. Checked into St David's @ 0530. Was in the EP Lab @0600. As always the EP crew was upbeat and fun right up until the point I was out and woke to pleasent nurse in recovery. I really thought I would be able to get to sleep early last night but as usual that wasn't the case. I finally requested a sleep aid and was out shortly after.

My wait for a room was going to be a while so once I was fully awake she ordered me lunch and brought my family back to visit while I was waiting.
I can't say enough about the atmosphere at both TC&A or St. David's as the staffing is fabulous.

Dr Natale was very pleased with how things turned out. He confirmed all pulmonary veins were isolated from previous procedures. And successful isolation of posterior wall of the left atrium using roof and inferior posterior lines. He also ablated along the left atrial septum, floor of the left atrium, left atrial lateral wall and interior roof of the left atrium. He also isolated the coronary sinus and left atrial appendage.

For those that have been following along since last year you will remember that Dr Natale did work on my coronary sinus and LAA at that time as well. I also had an organic afib episode that originated in my LAA while he was working his craft on my coronary sinus. This was after he had already done some work on the LAA.

As you who are veterans to this process here will already know how difficult the LAA is to ablated due to its consistency and proximity to other vital organs. This limits the the time that he can spend there. So even though he had twice visited my LAA there was still a little work to be done.

Also, most bennifit greatly from a single LAA procedure which may or may not completely isolate the LAA. The plus side to that is that not only does this eliminated Afib in some patients. It also increases the possibility that the LAA will still function properly eliminating the need for long term anticoagulants.

He did have some issues ablating my LAA as he normally uses a 15 mm lasso but it could not be engaged because the entrance to my laa is too small. So he just used the regular catheter and went into the left atrial appendage and isolated it that way by moving the the catheter around the interior.

When we talked this morning we went over everything that he did as well as possibilities for the future. Chances are at this point I will either be on long-term anticoagulants or we need to have the laa isolated with either of watchmen or a lariot sutcher approach. His concern at this point with a watchman would be sizing as there only two sizes and the fact that my laa entry is so small could be an issue. But that's all down the road.

He sent me home only on 25 mg metoprolol and 5mg Elequis twice a day. He does not want me taking the Flecainide unless I need it.



Edited 2 time(s). Last edit at 08/17/2019 10:46AM by rocketritch.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
July 24, 2019 08:49AM
Been back from Austin a few days now just relaxing. Have had one short run of ectopic since. Got it recorded on my Kardia. Looked mostly normal to me except it wasn’t a solid recording. Second recording right after was normal with 72bpm.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
August 05, 2019 01:13PM
Feeling really good since my latest visit to Austin. Only a few eptopics along the way.
Biggest issue now is getting back to work. Have my papers but have to go through an outside source to get back to work. We don't have STD and I wasn't off long enough to file a claim if we did.
Worst case is I get extra time off paid.
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Shannon
Re: My Ablation With Dr Natale (07/20/2018) with current updates
August 05, 2019 08:13PM
Sounds great Rich! Glad to hear it’s smooth sailing in these early days post ABL.

Cheers!
Shannon



Edited 1 time(s). Last edit at 08/05/2019 10:43PM by Shannon.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
August 06, 2019 12:25AM
Thanks Shannon. Haven't had a chance to order the hummingbird feed you suggested. We had some gardensong clear feed mix I've been using. They really like it.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018)
August 17, 2019 11:18AM
It's been a month since my latest ablation with Dr. Natale. All is well so far. I have been having a couple PAC's and PVC's but nothing lastng more than a couple beat's. They only occur when I lay down or after I've been sitting for a while.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
September 19, 2019 07:46PM
Not much new to report. Have had a few eptopics over the past couple weeks but that's it
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
October 19, 2019 09:24PM
It's now been 3 months since my ablation with Dr Natale. Celebrated today with a 30 bike ride and a couple hours ride in the convertible with my wife after I got home.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
October 28, 2019 06:00PM
43 miles on the bike today. My legs are tired but my heart was in it.

Tried to keep my rate below 140. Had an avg rate of 129 with a Max of 155 during the 3 hour outing. I didn't hit the 155 mark until near the end of the ride. There's a pretty long climbed at about the 38 mile mark.

Overall a good day
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
November 27, 2019 10:36AM
Just got the results back from my in home sleep study. I have mild sleep apnea-hypopnea syndrome. But since I have a history of affib I qualify for c-pap and more than happy to comply. The doctor placed the order so I should have a machine by next week I suppose. My AHI is 6.7/hr and my saturation dropped below 90% for 3.3% of the night.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
January 15, 2020 09:15PM
Been a while since I have given an update.

Everything has been good heart wise. I feel the occasional eptopic but that's it. I have been going to the gym regularly but have been having a hard time getting back to cycling. Not sure why but that's where I'm at.

I am getting some decent cardio at the gym when lifting. I am avoiding doing any real heavy weight and just doing high rep sets and combining 2-3 exercises per muscle group together. I'm hoping my interest in cycling comes back. We'll see once the weather breaks and I have opportunityto get out on a regular basis.
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ln108
Re: My Ablation With Dr Natale (07/20/2018) with current updates
January 15, 2020 09:31PM
Good news, Ritch. Long may your heart be at peace!

--Lance
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
March 09, 2020 04:28PM
Had a great first ride if the season today. 30 miles on the road. Life is good.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
March 29, 2020 06:12AM
Finished my week with ZIO patch now waiting on results.

Been feeling really good. Got a couple rides in on the bike this week. 60 miles between both days.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
March 30, 2020 06:35PM
Spoke with someone from Dr. Natale's office today concerning my ZIO patch results. Only thing that showed up were several short 4 beat runs of SVT's.

I'm very happy with those results as short runs like that are common even in those without arrhythmias. We will schedule a visit down the road to have a TEE done to check my LAA velocity. I also need to do a better job of keeping up with my suplimenatation of Mg and K.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
June 13, 2020 09:11AM
Haven't posted in a while since things have been normal. Unfortunately that came to an end the a week ago.
I was out of rythem for about 1/2 hour. Not sure what it was since my Kardia was out of commission due to it finding it's way into the washing machine.
I ordered a new Kardia Xl the next day and it arrived early this week. Just in time to capture my next event. I'm pretty sure it's AFib bit I'm not a pro at reading strips. I took flecanide to convert but converted moments after taking it so I self converted.
Not sure what triggered this as I have not been doing much besides work since the Covid-19 sent our lives into chaos. I've been going to the gym and some long needed yard work. But that's the extent of what I've been doing. I've only been on the bike a handful of times this year and now I'm not sure what to do.
I'll be calling Dr. Natale's office on Monday to see if they have any thoughts.
On a side note. Back when I first experienced AFib I was heavy into weight lifting. This was prior to my overindulgence in cycling.





Edited 2 time(s). Last edit at 06/14/2020 03:21PM by rocketritch.
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ln108
Re: My Ablation With Dr Natale (07/20/2018) with current updates
June 13, 2020 10:54AM
Sorry to hear about this, Rocketritch. Good to call Dr. Natale's office. I'm sure they'll help you get a handle on what's going on.

All best!
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
June 14, 2020 03:24PM
Thanks. I'm not sweating it at all. Roll with the punches as they say. Hopefully things will quiet back down and this will be just a passing glitch.

I also just had a wonderful conversation with Shannon which is always positive. I'll be talking with someone in Austin tomorrow and we will allow my heart to guide the course as usual.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
June 16, 2020 12:36PM
Spoke with Natale's office yesterday. They phones to set up a tele--conference for July 27. At which point we will discuss my current situation as well as LAA occlusion.

Dr Natale believes what I am experiencing is Atrial Tachycardia initiating within either the LAA or Coronary Sinus. However with only my Kardia recordings nothing is definite only a hunch based on the high heart rate which could also be a SVT. I believe he is basing his theory on my history and the work he has already done.

Until then I wait and hopefully things will quiet down. I'm currently just taking metoprolol 25 mg and eliquis 5mg. I have used Flecanide to convert twice now. The other times I self converted. The times I self converted the time of the run was under 5 minutes. When it goes much longer than that. Or if I have several short runs over a period of time I won't self convert. Or at least I won't in a period of time that is comfortable for me. That's when I take the flecainide.

I emailed the office today to see if they want me to possibly increase my metoprolol and maybe start a daily low dose flecanide regiment. Although, if I do go back on a daily of flecanide I won't know if things have settled down. I've been to this rodeo before and have had things go quiet and hopefully this will be similar.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
June 17, 2020 03:47PM
2 days now in NSR with only a few ectopics. Still feel out of sorts though. It's a feeling I've tried to explain to people but probably only symptomatic afibers can relate to. The best I can explain is that I feel hollow.

To add to my stress they just put the hammer that we will be working a 7/7 shift throughout 2020. We have been working this now for over a month. It's better than the 14/14 they had is working but barely.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
June 21, 2020 05:38AM
Spoke with one of Dr Natales Afib nurses the other day. they moved my appt up to July 2. She also wanted me to start back onto 150mg of flecanide 2x. Not real thrilled about that and not entirely sure its necessary at this time. Especially since I was having a pretty good run of NSR. I suppose though its better to try to keep it at bay instead of allowing it to progress.

Of course along with the flecanide comes the dreams. I have always had an increase in dreams when on flecanide for a period of time. THe bad thing about the dreams is they are generally not pleasant.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
June 25, 2020 01:28PM
My appointment has moved up to the 30th now. July 2 was not s good day for me since I'll be back on night shift and would have to wake up to make it.

I am still in NSR and still on the flec. I've reduced the amount I'm taking to 100mg instead of 150mg and have noticed no difference in my heart. I'm still not convinced I need it. There was allot happening leasing up to me going out of rhythm. 14 nightshifts in a row and other craziness/stress at work. Just their past couple days I worked 3 18 hour days in a row. Non of this was by choice.our companies response to Covid is a bit overblown and is causing allot of issues in our department especially the part I work in. There are only 8 of us to cover a 4 shift 24 hour operation and we were down a guy this past weekend.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
July 01, 2020 02:41PM
Spoke with Dr Natale yesterday. We discussed my current situation and what's been going on trying to figure out what might be causing me to go out of rhythm.There's nothing that I can point to to give him a clue as to why.
He did point out my uncanny propensity to have issues at certain times of the year. The only two things he really asked were that since I work night shift a lot if I was drinking coffee. Which I don't. I haven't purposefully had any kind of caffeine for well over 20 years.
The other question he asked was if I'd put on any weight. And to that I haven't. I am slightly heavier than I normally am but I haven't put on any weight in the past two years
The current plan is for me to stop the flecainide in a few days. I'm currently taking 50 mg twice a day. And see what happens
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
August 17, 2020 10:20AM
Have had allot going on lately. Actually it started back mid June.

I had a couple days when my heart decided it wanted to go out of rhythm. I had just come off a stretch of 14 night shifts and was working outside building a block wall. PIP easily converted but Natale's office wanted me to go back on the Flecanide until we could speak.

We had a tele-conference about a week later so he could get a feel for what was going on with me and could not pinpoint anything out of the ordinary besides the 14 night shifts. They had me stop the Flecanide a week later to see if I would stay in rhythm. This was also good as I was getting ready to start vacation at that time and would have around 21 days off and also be working daylight after returning. So almost a month of normal sleep patterns.

During that time I had zero rhythm issues and only a handful of noticeable eptopics.

On Aug 5th, On my last stretch of 7 night shifts. My heart went out of rhythm just before shift turnover. It lasted just long enough for me to get a recording before converting back naturally. Then on Friday (7th) morning I woke up to what I believe was a short run of eptopics. I felt fine the rest of the day an did a 15 mile bike ride that afternoon since I had kind of shy'ed away from the bike since mid June and had a larger ride planned with a friend of mine for Saturday. Everything was fine so I met my friend on Saturday for a 47 mile ride. I also did and another 15 miler on Monday and had zero issues.

So since Aug 5th I have had no issues and zero night shifts.confused smiley
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MissSunshine
Re: My Ablation With Dr Natale (07/20/2018) with current updates
August 17, 2020 11:26AM
So glad that it is resolving itself and not preventing you from living your life. Hope that you stay in NSR for the long haul.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
September 07, 2020 03:18PM
Sorry I haven't been updating this a lot lately I should do it more. I've had a couple More runs of afib since August 5th. Three to be exact. All occurred while I was just sitting around doing nothing.
However, I think I might have found a link or at least a trigger. I've been pulling my hair out trying to figure out what's going on as I go out of rhythm at rest. One thing I've been noticing is it seems to happen after I eat. Like I said I've been paying more attention since the latest onset of a fib and each time I've been burping or had something going on relative to my stomach.
I was in a discussion with some people on a another group that's cycling related. Everyone in the group either has afib or has had an ablation or is treating themselves homeopathically. During one of the conversations this other ad or discussion popped up talking about issues with the heart related to the stomach.
The article talked about hiatal hernias and other gastric issues affecting the pheneric nerve thus causing an arrhythmia. It also talked about a relation between CPAP and the gastrointestinal system and arrhythmias. Oddly enough not too long ago and when I was trying to put my CPAP on the air pressure was so high it was blowing the mask off my face. I was able to get it straightened out and get it to work so I did wear it that night and talk to the company and they investigated it and downloaded something to my machine. However it made me think that if it was doing that while I was awake what was possibly happening when I was sleeping.
Long story short I've been watching my diet and getting back to doing what I enjoy most which is cycling.
Since last Friday I've traversed over 120 mi. None of them easy. And it had zero issues. This doesn't make sense to me especially with my history with cycling and afib.
I'm to call Dr Natalie's office tomorrow and set up a teleconference so we can discuss what's going on with me. In the meantime I've been sending recordings mostly NSR to Kim. I've also been trying to give some clues to what I'm experiencing and when.
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NotLyingAboutMyAfib
Re: My Ablation With Dr Natale (07/20/2018) with current updates
September 12, 2020 10:53PM
Great thread Rich. I think you and I would be good riding partners once I get back to normal.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
September 21, 2020 08:45PM
Not much new. Been riding allot lately and it feels good to be back at it from a short sebaticle. Have also spent a couple days hiking. One day up in the mountains and yesterday for a short 2 mile hike at a local park.

I did speak with Dr Natale today. Based on recordings I have sent him and my personal accounts as to what's going on. He feels it a good idea to take one more crack at my LAA.

As stated before this is where I had an organic afib episode on the table that originated there after he had already done some work to it. According to what he said to me the last time I was there my LAA is of an odd size and he had to address it differently than he normally does. He also felt that I was on to something with the correlation between eating and the arrhythmias I'm experiencing.

He also wants to do a watchman at the same time if we can. That will get me off of the anticoagulant.
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Shannon
Re: My Ablation With Dr Natale (07/20/2018) with current updates
September 21, 2020 09:46PM
Sounds like a good plan, especially in your case and in light of your history Rocketrich.

Be well,
Shannon
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
September 22, 2020 06:17PM
Thanks Shannon.
It's all rather strange. What I'm experiencing now is almost identical to what I experienced back in the very beginning of my afib journey.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
October 10, 2020 12:51PM
Not much to report lately. Still riding and hiking on a pretty regular basis. As regular as working 7/7 schedule, with OT mixed in allows. I did experience a brief episode last Saturday towards the end of the ride. We had done allot of climbing including one ridge climb. This is the first time I allowed my Heart rate to go above 150 bpm. At about 3/4 to the top of the ridge I saw 173 and backed way off to not let it go any higher.

Towards the end of the ride I got split from the group as I hesitated at an intersection and had to wait on some traffic to pass. So I sprinted to catch up but still felt good at this point. A few miles down the road though my HR jumped to 188 bpm for about 10 seconds or so the right back to 149 bpm. Not sure if it was as short run of afib or a run of ectopic beats. My wahoo HRM just does HR nothing else. I felt fine the entire time and the remaining 5 miles were uneventful.

I have a visit scheduled with Dr. Natale for November 3 to hopefully address this final lingering issue and be done with it.

Oh and Goat YOGA is a thing. Who new?



Edited 1 time(s). Last edit at 10/10/2020 12:56PM by rocketritch.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
October 12, 2020 07:42PM
Nice short run this evening. All is well.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
October 21, 2020 08:13PM
Headed back to Austin next week for what I hope is my final trip. My episodes are still pretty spread out. And aren't having any real affect on my life. Other than being woken up from a deep sleep. Or one or two short episodes while exercising.

This is literally how things started out for me all those many years ago.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
October 28, 2020 12:26AM
Back in Austin today. Will be seeing Dr. Natale in the morning.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
October 28, 2020 07:27PM
Ablation went well today. Dr. Natale popped in for a few minutes a short time ago. My LAA was still during off causing my issues. Not sure what else he did.

If you have read through this post I have mentioned that my LAA is really small and that he is unable to use his normal LAA tool.

We will talk not tomorrow with the rest of his team.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
October 30, 2020 11:10AM
Getting ready to fly back home. Feeling really good besides being tired. Haven't slept a whole lot since Monday. Didnt even sleep through the night following my procedure. Nor did I sleep through the night last night. Maybe I can catch a nap on the flight home.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
October 31, 2020 04:10PM
Got home late last evening. Traveling during Covid is like taking part as an extra in some sort of weird Sci-fi movie. Where only a few people are aware of what's going on.
It's easy to tell who those are as they are the ones wearing Tyvek suits and full head covering masks and rubber gloves. These folks also spend an abundence of time cleaning their gloved hands with hand sanitizer. While the rest of us are obviously ignorant to the situation that we find ourselves in.
Anyways, our trip home from Austin was pretty boring. Had a two hour layover in Atlanta and a 2 hour drive home from Pittsburgh international. So it was a long day to say the least.
I did sleep really good last night though. Bed at around 11pm and out of bed @2pm today. I really needed it as I hadn't slept much since finishing up night shift Monday morning. Not counting surgery I was averaging about 4 hours a day this week.
Our stay in Austin was plesent but shorter than normal. We stayed in the downtown this time. Things were pretty quiet there this time. I'm sure it was mostly due to Covid and the normal afternoon/evening crowds we are used to seeing are people leaving work and hanging out. Who aren't there now due to working form home.
We did spend part of an afternoon on South Congress wondering through the small shops there.
I'm feeling really good today and looking forward to a week or so of just being.
I can't express enough how appreciative I am of Dr. Natale and his team. As well as the staff at St David's. I really tried to convey that to everyone but still feel I need to do more.





Edited 1 time(s). Last edit at 10/31/2020 04:11PM by rocketritch.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
November 01, 2020 07:18PM
Still sluggish today. I can't say that I have ever felt the same following an ablation. Each time has its own little nuances.

One major difference this time around was my fitness level going into it. Not nearly as fit as I was back in 2009 but a far cry better than 2018 & 2019. Actually I would like to completely forget about 6 months worth of 2018 if it were at all possible.

Still sluggish today. Didn't sleep as well as I thought I would last night. Heart rate is rather low. Lingering between 54 and 64. I am currently only on Elequis and 25mg of metoprolol. I should be able to toss the metoprolol at the end of my blanking period so 3 months of governored heart rate which I am more than happy to deal with.
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MissSunshine
Re: My Ablation With Dr Natale (07/20/2018) with current updates
November 01, 2020 07:32PM
Thank you for the updates. Where did Natale ablate this time? Are you having any ectopic beats? I apologize for not remembering if you had a watchman implanted. But, if you did, how does the EP ablate around that. Wishing you all the best and that the beast is finally put to sleep.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
November 04, 2020 11:57AM
During the ablation it was found the my LAA was still causing an issue. This is the third time Dr. Natale has addressed my LAA. My LAA is of a shape and size he is unable to use his normal tool to isolate it. So he has to use a different technique. Which, adds a level of difficulty due to the structural make-up of the LAA.

He also addressed a right atrium, non-sustained arrhythmia triggered by targeted electrograms. Superior vena cava isolation was also performed.
(Shannon if your reading this please chime in for more detailed clarification of LAA or anything else for that matter.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
November 11, 2020 01:04PM
Not much new to report. In NSR with no noticably eptopics.

Been taking it easy though with the beautiful weather staying off the bike was hard to do. I did spend a couple days doing some light yard work.

At the gym right now easing myself back into that. Limiting myself to 1/2 my normal training loads. Plan to get out and do some hiking this week. Had planned to go today but the weather went from warm/☀️/dry to 🆒/ ⛈️.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
November 19, 2020 03:41PM
My work decided it would be a good idea to test out my most recent ablation today.
Had a call off last night so I got to leave for 6 hours and come back to work another 16. Top that off with a multitude of alarms and faulty equipment first thing pushing stress levels from 0-100.
Oh well. I'll get to leave for 8 hours tomorrow morning @0400
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
November 26, 2020 08:49AM
Woke up from some really weird dreams today in tachycardia. This lasted for about 15 minutes after I woke up before converting back to NSR. This is the first issue I have experienced since my ablation in October.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
December 13, 2020 11:02PM
Not much to report. I did have a brief syncope incident on Thursday. I had been to the gym then was running some errands. It was in my last stop when it occurred. Not sure what brought it in as I felt fine.

I have had brief syncope events since I was very young but only when standing from a sitting position. When those happened things would just go dark but I never passed out. I would just keep moving or if it lasted a little while longer I would just stand there and wait for the lights to come back on. I never got the deck during those brief episodes. I have however found myself on the ground a couple times in recent years. Once prior to my ablation in 2018 and once about a year or so later. Fortunately I was at home when these 2 happened.

I continue to spend several days a week hiking. Did about 20 miles over 3 days last week. Headed out in the morning for a 9 mile jaunt.There are some great trail systems throughout the mountains here in Pennsylvania. I did a 5 mile hike last week at a local recreation area. Part of the area belongs to the county and the other a local college.

The county side has just a trail system. The college side has trails, disc golf, a very short ski/sledding hill and a par course. The course is made up of several stations where you do different exercises. These range from situps to pull ups and everything in-between. My hike only took me through part of the course but it was a good workout.



Edited 1 time(s). Last edit at 12/13/2020 11:14PM by rocketritch.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
December 17, 2020 07:21PM
Had allot of snow here yesterday through this morning. Got home and there was no way to get into my driveway. So I hit the 4ways and gathered up the snowblower.

I had already moved 4" before going to work and from what my wife said her and my son moved another 12" in the evening. They had to use shovels though since I pulled the start cord from the blower when trying to start it earlier in the day. So they didn't do as much of the drive as I had earlier.

Moved snow until around 8:30 and went to bed. Back to it at 1:30 to finish digging myself and neighbor out. No heart issues at all. What a great feeling.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
January 27, 2021 07:29AM
Nothing new to report. I did have an Echo done the other day. All results were basically normal so far as I could tell. I have an appointment with Dr, Natale next Friday.

Still on Elequis and Metoprolol. The Elequis is forever so far as I can tell. I do hope to get off the metoprolol. I actually already don't take it on days I'm off work. As I am more active on those days and like not having to deal with the side affects.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
February 16, 2021 12:36AM
Had a virtual visit with Dr. Natale and Jacquie Kin this afternoon. He is very pleased with my current situation as I am. We are currently working towards me getting a watchman implanted.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
May 14, 2021 12:15PM
Not much to report. Have had a wonderful winter and spring. Hiking, snowshoeing and XC skiing all winter. And cycling this spring.
Ride a rollercoaster today for the first time in many years.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
August 26, 2021 08:24AM
Haven't posted in a while. no news is good news as they say and that's right where I am right now.

I still get the occasional ectopic but beyond that nothing but NSR.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
October 09, 2021 04:52PM
Nothing new to report from here these days. NSR is wonderful but not very exciting or controversial worth writing about.

I am fighting to keep from falling back into old habits that most likely lead me here. I've been doing good keeping things in check on the bike. However, I have started running with my son a few days a week and have been letting my heart rate get higher than I normally do on the bike for extended periods.

I've also been doubling up by riding earlier in the day 30 - 50 miles. Then hitting the track with my son later in the day. I need to start wearing my HRM when we run as I'm just using the on on my Garmin watch which probably isn't the most accurate. Though on the bike it seems to be within an acceptable range to the chest strap.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
January 07, 2022 01:23AM
Happy New Year everyone!!!!! smileys with beer

Not much to report these days. still get a few ectopics but other than that its been wonderful NSR 24/7. Been doing allot of hiking this fall and winter. Hoping to get some snow before spring to be able to get out on the XC skis and or snowshoeing.

The only real exciting thing is that my son ad I both had covid right after Thanksgiving. Fortunately we were both recovered before Christmas and were able to spend time doing the things we like to do and spent allot of time with family. Had a great New Years Eve In the city.
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rocketritch
Re: My Ablation With Dr Natale (07/20/2018) with current updates
January 11, 2022 05:51PM
Got a call from Texas Cardiac & Arrhythmia to schedule a watchman procedure for February. May not be able to do February but will definitely be making arrangements.

This is completely out of left field for me as last Dr. Natale and I spoke I was not eligible. I phoned and left a message with the scheduler as well as an email to Trent requesting information as to what has changed.
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