Re: Count down to PVA with Dr. Natale in California

[Guest guest]

After living with AFib since I was officially diagnosed in March of

1985 as Para AFib, breaking through every know medications over the

years, trying alternative diets, then finally going into chronic

afib I'm finally getting a PVA done. After waiting nearly a 1 1/2

years since my initial consultation with Dr. Natale in March 2003

I'm set to have the PVA done by Natale on August 12th at 3:30PM at

Marin General in California

I have been in chronic AFIB for 5+ years, controlled on diltiazem

and Carvedilol. I had been scheduled to have the PVA done June 2nd

but a few weeks earlier they realized I was only on asprin and they

wanted me thearaputic on coumadin for a minimum of 4 weeks prior to

the procedure. I was switched from asprin to coumadin about 6 weeks

ago and its been 3 weeks since I reached an INR level of 2.0, the

minimum thearaputic level. I'm at 2.3 as of today but they'd like me

to reach an INR level of between 2.5 and 3.5. I have just been

advised to increase my dosage from 9 mg every day to 9 mg 3x per

week and 10 mg the rest of the week.

I've completed a heart scan (via a CT Scan) and echo as they've

required of me. I will have a TEE done 1 hour before the

procedure.

I've gotten my insurance lined-up. When I had gone in for my INR

blood test at an out of state hospital apparently that triggered the

pre-existing conditions unit at the insurance company (Blue Shield)

to step in and see that I was compliant. I was.

Working with the Marin folks had not initially been an easy endeavor

but I've got the system figured out now. I've learned you need to

be very proactive to see where you are on the schedule and that you

have all their requirements completed before the PVA. It takes some

effort to make sure everyone within their organization is talking to

each other and coordinated.

Hopefully I can knock out this afib in one procedure. I'll keep you

posted. See my earlier messages #20935 and 7607 for more info on me.

Bruce

> I met with Dr. Natale for a consultation in March 2003 when he

came to

> Greenbrea (in Marin County), CA. He comes to California 2 days

each

> month. I was put on the calendar to have him do the PVA(I)

procedure

> on me in September 2003. I got bumped to October 2003. I just

found

> out the other day that there is such a backlog, roughly 20 people,

> vying for 4-5 slots that I am being bumbed again to December 2003

at

> the earliest and most likely not until next year.

>

> Is this backlog typical? Does anyone know what the wait would be

to

> have the procedure done in Cleveland? How about in France?

>

> BACKGROUND ON MY AFIB: I have been in Chronic AFIB for a few years

and

> currently on meds for rate control. I was diagnosed initially with

> paroxysmal AFIB in 1986 by the US Navy when I was a pilot which

> evolved to persistent then chronic over the years. I'm active and

> exercize regularly but I really want to get off the meds and get

back

> my atrial kick. I've broken through just about every med out there

> since 1986.

>

> Regards,

> Bruce Whitson

> Palo Alto, CA

[Guest guest]

> Good luck to you Bruce. I'm sue all will go well. It sounds like

you dotted

> all the " i " and crossed all the " T's " . By the way. I used to live

in Palo Alto

> back in the early Eighties. I ran the Hubbard & operation

in Mt. View,

> on the El Camino.

> Rich O

>

Small world. I used to shop at H & J in Palo Alto. Great store, very

knowledgeable(sp?) staff.

[Guest guest]

Bruce, a couple of items in your current posts and in your quoted post

from October of last year piqued my interest.

I, too, am an ex-Naval Aviator (A-6s), and I have to wonder if we

Wings of Gold types, as generally certifiable adrenaline junkies, are

possibly predisposed to AFib because of frequent periods of adrenergic

stimulation... Until I got hit with my current persistent AFib a

couple of months ago, I would have occasional instances (palpitations,

tachycardia) which in retrospect I believe to have been PAF, generaly

resulting from " overstimulation " situations... (Trying to find that

cat shot or ACM again in the civilian, earthbound world???) I ran

seriously (3 marathons, 3:17 best, training 40-70 miles/week...) for a

few years between quitting smoking and birth of my daughter 17 years

ago, substantially building up my cardiopulmonary system, and when I

had one of those instances, I was generally out of shape and could

make the symptoms go away by getting back into shape. Not this time...

My pulse rate is controled (upper 80s, about 20-25 points above my " in

shape " rate) but irregular as hell... I can't count it accurately

myself.

Second, you note that you are on rate control meds and that you

exercise regularly. I'm seeming to find those two concepts mutually

conflicting, as my rate control meds (digoxin and Toprol XL) seem to

preclude any sort of rate acceleration if I try to significantly

increase my workload. In what sort of regular exercise are you able to

engage while on rate control meds? I'm " active, " walking the dogs and

walking around quite a bit, but substantially increased workload

doesn't/can't cause acceleration in my heart, and as a result I get

into shortness of breath (and some muscle fatigue, although that could

be the Lipitor, which I've also recently started at 20Mg QD for mild

[no measurable stenosis] atherosclerosis in one of the three cardiac

arteries...) pretty quickly...

I've been therapeutic INR (2.3-2.6) for more than three weeks, and my

local card has me scheduled for DC cardioversion at the end of this

week. I'm scheduled for a consult with Natale in Cleveland on Tuesday

of next week, however, and will probably defer the cardioversion until

after I see Natale. My research seems to indicate that DC

cardioversions don't " stick " very well, even if initially successful,

for persistent AFibbers, so I'm looking to a Natale PVA for a

high-probability permanent fix and relief from medication.

Tony Rairden

> > I met with Dr. Natale for a consultation in March 2003 when he

> came to

> > Greenbrea (in Marin County), CA. He comes to California 2 days

> each

> > month. I was put on the calendar to have him do the PVA(I)

> procedure

> > on me in September 2003. I got bumped to October 2003. I just

> found

> > out the other day that there is such a backlog, roughly 20 people,

> > vying for 4-5 slots that I am being bumbed again to December 2003

> at

> > the earliest and most likely not until next year.

> >

> > Is this backlog typical? Does anyone know what the wait would be

> to

> > have the procedure done in Cleveland? How about in France?

> >

> > BACKGROUND ON MY AFIB: I have been in Chronic AFIB for a few

years

> and

> > currently on meds for rate control. I was diagnosed initially with

> > paroxysmal AFIB in 1986 by the US Navy when I was a pilot which

> > evolved to persistent then chronic over the years. I'm active and

> > exercize regularly but I really want to get off the meds and get

> back

> > my atrial kick. I've broken through just about every med out

there

> > since 1986.

> >

> > Regards,

> > Bruce Whitson

> > Palo Alto, CA

[Guest guest]

Bruce, a couple of items in your current posts and in your quoted post

from October of last year piqued my interest.

I, too, am an ex-Naval Aviator (A-6s), and I have to wonder if we

Wings of Gold types, as generally certifiable adrenaline junkies, are

possibly predisposed to AFib because of frequent periods of adrenergic

stimulation... Until I got hit with my current persistent AFib a

couple of months ago, I would have occasional instances (palpitations,

tachycardia) which in retrospect I believe to have been PAF, generaly

resulting from " overstimulation " situations... (Trying to find that

cat shot or ACM again in the civilian, earthbound world???) I ran

seriously (3 marathons, 3:17 best, training 40-70 miles/week...) for a

few years between quitting smoking and birth of my daughter 17 years

ago, substantially building up my cardiopulmonary system, and when I

had one of those instances, I was generally out of shape and could

make the symptoms go away by getting back into shape. Not this time...

My pulse rate is controled (upper 80s, about 20-25 points above my " in

shape " rate) but irregular as hell... I can't count it accurately

myself.

Second, you note that you are on rate control meds and that you

exercise regularly. I'm seeming to find those two concepts mutually

conflicting, as my rate control meds (digoxin and Toprol XL) seem to

preclude any sort of rate acceleration if I try to significantly

increase my workload. In what sort of regular exercise are you able to

engage while on rate control meds? I'm " active, " walking the dogs and

walking around quite a bit, but substantially increased workload

doesn't/can't cause acceleration in my heart, and as a result I get

into shortness of breath (and some muscle fatigue, although that could

be the Lipitor, which I've also recently started at 20Mg QD for mild

[no measurable stenosis] atherosclerosis in one of the three cardiac

arteries...) pretty quickly...

I've been therapeutic INR (2.3-2.6) for more than three weeks, and my

local card has me scheduled for DC cardioversion at the end of this

week. I'm scheduled for a consult with Natale in Cleveland on Tuesday

of next week, however, and will probably defer the cardioversion until

after I see Natale. My research seems to indicate that DC

cardioversions don't " stick " very well, even if initially successful,

for persistent AFibbers, so I'm looking to a Natale PVA for a

high-probability permanent fix and relief from medication.

Tony Rairden

> > I met with Dr. Natale for a consultation in March 2003 when he

> came to

> > Greenbrea (in Marin County), CA. He comes to California 2 days

> each

> > month. I was put on the calendar to have him do the PVA(I)

> procedure

> > on me in September 2003. I got bumped to October 2003. I just

> found

> > out the other day that there is such a backlog, roughly 20 people,

> > vying for 4-5 slots that I am being bumbed again to December 2003

> at

> > the earliest and most likely not until next year.

> >

> > Is this backlog typical? Does anyone know what the wait would be

> to

> > have the procedure done in Cleveland? How about in France?

> >

> > BACKGROUND ON MY AFIB: I have been in Chronic AFIB for a few

years

> and

> > currently on meds for rate control. I was diagnosed initially with

> > paroxysmal AFIB in 1986 by the US Navy when I was a pilot which

> > evolved to persistent then chronic over the years. I'm active and

> > exercize regularly but I really want to get off the meds and get

> back

> > my atrial kick. I've broken through just about every med out

there

> > since 1986.

> >

> > Regards,

> > Bruce Whitson

> > Palo Alto, CA

[Guest guest]

(SNIP)

> The only thing I found is that unless you have some underlying

> structural issue with your heart, e.g. valve problem, our wiring is

> simply screwed up.

(SNIP)

I was just at a major trade show for the music industry last week, and

found that more than a few of my boomer and pre-boomer peers are

having some sort of cardiac complication in their lives. Most are

getting stents for atherosclerosis. I tell them that they're dealing

with the plumbers and mechanics, while we AFibbers are dealing with

electricians...

tr

[Guest guest]

(SNIP)

> The only thing I found is that unless you have some underlying

> structural issue with your heart, e.g. valve problem, our wiring is

> simply screwed up.

(SNIP)

I was just at a major trade show for the music industry last week, and

found that more than a few of my boomer and pre-boomer peers are

having some sort of cardiac complication in their lives. Most are

getting stents for atherosclerosis. I tell them that they're dealing

with the plumbers and mechanics, while we AFibbers are dealing with

electricians...

tr

[Guest guest]

(SNIP)

> The only thing I found is that unless you have some underlying

> structural issue with your heart, e.g. valve problem, our wiring is

> simply screwed up.

(SNIP)

I was just at a major trade show for the music industry last week, and

found that more than a few of my boomer and pre-boomer peers are

having some sort of cardiac complication in their lives. Most are

getting stents for atherosclerosis. I tell them that they're dealing

with the plumbers and mechanics, while we AFibbers are dealing with

electricians...

tr