the thread of ATRIAL FIBBING

worst things abt recovery:

i: mild urine retention as anaesthetic wears off (it damps down yr automatic body processes for a day or two)
ii: shoulderblade really really REALLY itchy where the sticky pad was for best electrical contact and conduction -- just where i can't reach to scratch it

(it has been pointed out to me that it was the apostle PETER, not paul, who thrice denied before the cock crowed etc…: a fact-check that needed ticking off professionally speaking, and shame on your heathens for none of you noticing :D )

Ach peter is canon but I'm always up for reinterpretation

Just looked up "catheter ablation." I assume it's less daunting than its description makes it seem.

And looked up A&E, which means Arts and Entertainment in the U.S. I see it's Accident and Emergency elsewhere, "a hospital's emergency department in many countries." Note that Mark's account effectively combines the two departments (Accident and Entertainment; alternately, Arts and Emergency).

Best of luck.

re catheter ablation: on one hand, yes, YIKES :0

on the other, heart-related procedures (associated with basically healthy people) are in the main surprisingly routine these days (and if something goes awry i'm in the best place)

(ie if i have a heart attack at home alone in bed, i'm in a bad position to do something about it; if i'm in surgery (and fast asleep) others are in an excellent position to do the right things about it)

consult yesterday re next stage: a range of options, from carrying on meds as is -- fine in the short term, outlook less good in the very long term (= my heart will wear out quicker) -- to ABLATION, see above. I am up for this and so is she: if her colleagues agree it's indicated it will take place at BARTS, a fact that pleases me for some reason (I had to go google where Bart's actually is, naturally it is two buses rather than one).

Above I said the ABLATION will work by burning and sometimes they do, but this -- as the condition is very likely relatively recent -- will be by FREEZING, which also pleases me.

(I am pleased by strange things, hullo have you met me this is hardly startling news)

so anyway i'm once again waiting for a letter

St Bart's is the only place in London I've gone under the knife - I'm sure they'll take good care of you, Mark - will you be in for a while, optimally?

From googling ablation: "Your doctor uses heat, cold, or radio energy to scar some tissue inside your heart" - I assume you get to choose based on which powers you want to activate?

day patient, apparently, unless there's any leakage problems after the op

Do they leave you with an iron man window in your chest

it me, shortly:
https://www.youtube.com/watch?v=SRH-Ywpz1_I

you know who else wanted a window in his chest?

letter arrived: procedure will be CRYOBALLOON ABLATION, prep for which includes switching onto AMIODORONE once my most recent tests (liver and thyroid) come back

(not yet sure if i'm coming off anything, GP is checking)

everything fine otherwise: the tiredness got much better when i switched the times i took my meds but i'm noticing it's slightly worsened again? it's aggravating bcz i want to lose a bit of weight but being tired when i need to get stuff done that requires brainwork makes me snack unhelpfully

sending you good thoughts mark. i had an ablation procedure (for SVT) a few years ago and it went just fine - went home the same day. for mine, they had to do something (burning prob) to stop the electrical pathway that could sometimes trigger a very fast heartbeat. i was tired the next couple days after and for a while had what they told me was 'increased cardiac awareness' but it's settled down. mostly don't worry about it any more except now i hardly ever drink because that triggers it, though now i can easily get the rapid heartbeat to slow down myself so no more trips to the ER. definitely glad i had it done.

in the best version of this procedure, i wd actually be piloting the cryoballoon thru my own vascular system, like a cross between FANTASTIC VOYAGE (1966) and AGAINST THE DAY (2006)

https://www.researchgate.net/publication/225277143/figure/fig4/AS:267857774772257@1440873678562/Figure-1-Anatomy-of-a-Cryoballoon-catheter-Courtesy-Medtronic.png

I just talked with a friend who recently had this procedure. He reported that the most disturbing aspect was that whoever shaved his groin didn't just do the side where the cath was being insert, he/she also shaved the other side to "keep it even." Also that the shaving happened in such close proximity to his balls.

update observation re AMIODORONE (i assume, as it's the new med and hence the one producing the changed state?): mostly i'm fine but i do now and then get days when i'm just tired and listless (ie yesterday, despite a good night's sleep; whereas last night i had much less sleep and was restless, yet today i'm not really tired at all)

i have a provisional cryoballoon procedure date = 27 sept (sooner than i expected after my consult on mon but that's good not bad)

really starting to notice the tiredness most days now -- but my procedure is this coming wednesday so fingers x-ed it will change things somewhat

Good luck! Hope this works out.

aaaaaaamen, be well mark

the device being deployed is the ARCTIC FRONT ADVANCE CRYOBALLOON, which sounds bracingly Warfare-of-the-Near-Future

It's my party and I'll cryoballoon if I want to. See you at the FAP next Thursday.

Good luck tomorrow, man.

Good luck, Mark.

best wishes, mark, hopefully this will do the trick

All the best for today mark s

crossing furry toes

Best of luck today mark s

hope it goes well!

best wishes mark s!

Yeah good luck Mark!

i'm back baby, awoooo!

details when i'm less tired

*celebration*

\o/

unable to contain this gem from the report (which i probably shouldn't already be reading): "owing to his very difficult anatomy…"

*beams with irrational pride, like i composed a brian ferneyhough sonata or something*

see above: "your heart is very stubborn, sir"

LOLz (xp)

Raises glass: "Tuplets to you, sir, and to the chambers of your heart!"

(Had to look up "Brian Ferneyhough.)

*beams with irrational pride, like i composed a brian ferneyhough sonata or something*

v gd tick

report as promised, three weeks on

Day 1 is mostly waiting (10am-4pm), until a doctor arrives to explain the procedure: a catheter up sent from a large vein in my leg to go inside my heart, with an inflatable cryoballoon attached. This will precision-target and freeze surfaces on my pulmonary veins, to discourage and ideally stop entirely the rogue electrical signals they send off, which is the cause of the fibrillation. The procedure also involves more cardioversion: this I didn’t know. I will be under local anaesthetic and sedation: so woozily aware of everything going on. There will be freezing sensations, a possibility of headaches — if too grim I ask for more morphine, morphine is so great :) — and “twitching sensations” in my chest, which “some people dislike”.

On the way to the operation theatre, I'm asked whether I have taken APIXABAN regularly: I have to respond that — having not missed one for six months — I somehow forgot one yesterday morning. She thinks this will be OK, and the surgeons within happily concur, missing one72 hours ago probably not a problem (I've been on it for abt six months). The room is large, full of busy people, some of whom greet me, and buzzing with technology. The bed in the centre seems oddly in shadow and neglected: of course bright lights will snap on and everyone will shortly gather. The team introduce themselves: they refer to the anaesthetist as the “barman” (since he’s in charge of stuff to make me feel good). This is mildly funny the first time. I am going to be (woozily) awake so I quite enjoy the banter, and the transparent moves to make me psychologically comfortable.

Local anaesthetic and sedatives in via my upper thigh: a very slight prick, as ppl say. And it begins: without feeling especially present, I can listen to the surgeon and assistants talking their way through what’s happening and what they can see: which resembles a slow, intricate, not very exciting video-game: basically they are manoeuvring a vehicle through a maze, sometimes encountering puzzling surroundings and uncertainty of direction. At a particular point the “twitching” begins: they have undersold this, to say the least. The cardioversion — the “twitches” — in fact means a fair number of electric shocks (just as it did upthread, except I’m not under general anaesthetic this time). It’s not grimly painful or particularly scary (after all, I’m sedated, and they willingly up the morphine), but it is kind of teeth-grindingly horrible. (Literally: I realise afterwards I dislodged a filling, presumably from clamping my teeth tight.) I’m woozier now — but still vaguely aware they’ve done three of the key veins, but not the fourth. They’re debating which the fourth actually is, I assume of the visit they have in front of them. I dimly remember them deciding not to proceed after fixing the third vein, and backing the vehicle out again beep beep. Don’t remember being wheeled back to the ward — vaguely remember being wheeled to a different recovery ward (which had more free beds).

A not-very-comfy night follows (my first ever overnight in a hospital), since the meds are wearing off and my abdomen feels (is) extremely bruised, on the inside of my ribcage. I get some sleep, jolted awake every time I move. I should probably have asked for some paracetamol at this point.

In the morning, a doctor comes and tells me it went OK, except for the vein they didn't treat -- he thinks the procedure will work without its being treated, but we won't know if the cryoblation has taken for a few months (basically while scar tissue forms and blocks off the rogue signals). If I do need a further procedure, they can use a different device this time, much better suited to locating the fourth vein. Fingers crossed.

Actually getting out of the hospital was a bit of a trial -- first they wouldn't discharge me until I'd had two further ECGs (to check a "leakage" a doctor said "probably wasn't a problem at all" -- it wasn't) and then actually being in the right ward at the right time to be seen and talked to by the right person. I was maybe nine hours sat, dressed, by a bed (meaning someone else was denied this bed), until this was properly and officially sorted, and I had to make a bit of a fuss. (I was cross and bothered by then as I couldn't get a signal -- you often can't in hospitals -- to liaise with my sister about picking me up (we then had to catch a train to get to hastings in time to fetch my niece from school).

Main symptom since: some fibrillation still (to be expected whether or not the procedure was a success) and considerable fatigue (ditto). I'm a lot less tired this week -- taking care to do nothing more strenuous than fite on ilx, and getting a LOT of sleep. Thursdays continue to be the days I'm most tired.

lol the man in the bed opposite when I woke up in the morning was a very chatty 9/11 truther, obsessed with the Fall of Building 7. Luckily I was tucked away in an alcove behind a curtain and he mainly directed his obsession at the little old man in the bed next to his, doubtless setting the man's recovery back by weeks.

https://www.scholastic.com/content5/media/products/14/9780439241014_mres.jpg

keep watching the skies!

Mediterranean diet.

In this cohort of atrial fibrillation patients, gut‐derived lipopolysaccharide (LPS) levels were predictive of major adverse cardiovascular events and negatively affected by high adherence to Med‐diet. LPS may contribute to major adverse cardiovascular events incidence in atrial fibrillation by increasing platelet activation.

Italian research shocker

lol i had to read the conclusion three times before i worked out that yes, it meant the med diet is good not bad, in ref AF

(thank you for posting)

They could have used more editorial assistance on that abstract.

sanpaku are u no longer vegan???

so i went for my six-week check-up this morning and it turns out that my heart rhythm is now back to normal, so the procedure worked as intended!

i will still be on meds and under observation for a while -- the condition is known to revert now and then -- but hurrah! the consultant was very cheerful and happy and so am i

(also i quizzed him and it turns out my heart architecture is genuinely actually cap-D Difficult, in respect of the technology they were using -- this wasn't just a polite way of saying i'm overweight and it was hard to find anything in the layers of flab, which is what i'd gloomily assumed) ("don't worry! if that had been the problem we'd definitely say very clearly")

DOUBLE HURRAH!!!!