First Post: Five questions

[Guest guest]

Ron, does your doctor know you get pain and pressure in your chest, you are

too dizzy to stand and that you are incoherent during some episodes? I cannot

imagine why your treatment is not more aggressive. Have you had a treadmill

and echocardiogram to rule out any other heart issues? Have you ever had a

cardioversion? Are you on blood thinners? You probably should be.

Someone has recommended Sotalol so you must be seeing a cardiologist or EP.

(Some people are hospitalized when this is started, some are not.) What most

people around here recommend is being the squeaky wheel. If I suffered

symptoms like this I would plant myself in the doctor's waiting room and not

move a

muscle until he/she did something about this problem *immediately.* You have

to speak up and speak up again and insist you will not tolerate these

symptoms. The doctor isn't suffering from them, you are. You will get a lot of

support and information here. Good luck.

Lil

In a message dated 4/23/2006 8:13:18 PM Pacific Standard Time,

ronnysully@... writes:

) My symptoms often include chest pressure and pain, and when in

afib I am often too dizzy to stand-up, and find that I am often

incoherent. Is this normal? Do others experience afib like this?

[Guest guest]

This is my first post. Background: 45 YO male, very active, 3 little

children.

I have been suffering from Afib for about 6 years, but over the past

18 months, afib has gotten to the point of interferring with my life.

When I am in afib, often I am so dizzy and exhausted that I have to

laydown until I convert. I have been missing work, activities with my

kids, etc. and I am very concerned about my health.

I am on Toprol and Digozen and my new doctor suggested Sotalol.

Generally I am experiencing afid 10-25 times per week, lasting from

several minutes to over 30 hours.

My quesitons for the board are as follows:

1) My symptoms often include chest pressure and pain, and when in

afib I am often too dizzy to stand-up, and find that I am often

incoherent. Is this normal? Do others experience afib like this?

2) What are the long-term implications of afib? does is reduce one's

life expectancy? Does it damage the heart? Increase the risk of

heart attack?

3) I have been encouraged by the potential of ablation, yet my old

doctor and new doctor were very reluctant to recommend this for me.

What is the criteria for ablation? What are the risks and success

rates? If you have had an ablation, what type did you have, where, and

how did it work for you?

4) Is there any concern or relationship beteen Afib and exersize that

I should be aware of?

5) Is sotalol generally administered in the hospital at first, or am I

confused with something else?

Thanks

Ron

[Guest guest]

Lil said:

> Ron, does your doctor know you get pain and pressure in your chest, you

are

> too dizzy to stand and that you are incoherent during some episodes? I

cannot

> imagine why your treatment is not more aggressive.

Lil,

Sounds like Ron's doctor might be playing a little too much golf and not

really paying that much attention to his work, huh?

I find your postings to be very imformative. It seems from what you are

saying, " being the squeaky wheel. " etc, that you and I are not that far

apart on our opinion of most doctors. I went to see my cardio last week and

it was not an uplifitng experience. I explained to him and showed him info

from the pharma drug data sheet on Toprol, how 8% of the population does not

metabolize the drug and thus does not eliminate it from the blood stream, so

it just builds up. I must be one of those people, lacking the CYP2D6

enzyme, and thus definitely OD'd on Toprol when I first started on it. In

addition to knowing nothing about it, he doubted what the data sheet said !

! Previously I had asked him why all the urination for the first hour when

I go into AFib and he said he didn't know. I showed him the posting from

Jerry explaining why, and he said he knew that.

Then I asked him if they (big med center of cardios) ever checked for

hyperthyroid. He said he could do that test for me if I wanted. I asked

him about Ablation, Maize and Mini Maize, as no one at his office had

mentioned them to me after 8 mos. (I learned about them here, on the list)

He said he didn't know much about those procedures and I could go see an EP

if I wanted.

So, after seeing these guys for 8 mos., and paying about $400 an hour for

their advice, I had been negligently overdosed on a drug, not been tested

for something that could be an easy fix, and not informed about various

procedures available that might affect a cure. I decided to take

responsiblity for my own health. I have gone to my regular doctor, who I

trust, and he ordered a whole bunch of tests that I wanted (including

thyroid), plus some others he suggested, the tests are done and when I see

him on Tue, I will have a clearer picture of what is happening to me. Plus

my regular doc only charges about $200/hr for his advice.

My cousin who is a specialist in internal medicine, tells me doctors

screw up all the time, and most patients never have any idea, cause the

doctor won't tell them, and no other doctor will either. When my cousin got

cancer, and he had to be a patient in the system, his whole opinion of the

system changed. He was appalled at the sloppiness and incompetence that was

routine. He had been especially conscientious in his practice and as a

result became very successful. He thought other doctors applied the same

standards he did. He is now a huge critic of the system.

Jim

[Guest guest]

> This is my first post. Background: 45 YO male, very active, 3 little

> children.

>[sNIP]

> My quesitons for the board are as follows:

>

> 1) My symptoms often include chest pressure and pain, and when in

> afib I am often too dizzy to stand-up, and find that I am often

> incoherent. Is this normal? Do others experience afib like this?

Hi Ron, welcome to the group. Symptoms vary quite a lot amongst AFers

but yours sound like they are at the annoying end of the scale

(certainly not uncommon but enough to make you want to change the status quo)

> 2) What are the long-term implications of afib? does is reduce one's

> life expectancy? Does it damage the heart? Increase the risk of

> heart attack?

I think the long term implications depend on how well you can manage the

AF. I think, on average, mortality rate doubles in AFers (but two times

a very small number is still a very small number!) High heart rates

during AF is one thing that can lead to other heart problems so if you

can keep the rate under control when you are in AF you can go a long way

to staving off other problems. Stroke is another concern but the risk

varies a lot depending on your circumstances so you might not need any

meds or you could go on warfarin (or some other anticoagulant).

> 3) I have been encouraged by the potential of ablation, yet my old

> doctor and new doctor were very reluctant to recommend this for me.

> What is the criteria for ablation? What are the risks and success

> rates? If you have had an ablation, what type did you have, where, and

> how did it work for you?

Criteria vary but many doctors like you to have tried a least a couple

of meds first. Being relatively young and having symptomatic AF certainly

tick a couple of boxes that make you a good candidate. Risks and success

vary quite a lot from EP to EP (so the trick is to find a good one).

>70% success and <5% complication is my gut feel for where we are today

in the better than average centres. I've had two ablations (Segmental

Pulmonary Vein Isolation) and I've had no AF since the second one on 9th

Feb this year. (I'm in the UK and had it done at the Newcastle Freeman

hospital)

> 4) Is there any concern or relationship beteen Afib and exersize that

> I should be aware of?

I think that depends on which doctor you talk to, opinion is divided. My

non doctor opinion is that you should avoid exercise that puts you into

AF (or makes you feel unwell afterwards) and if you suffer from high

rates in AF I'd be tempted to not push exercise too much even if it

wasn't causing you a problem. (i.e. lower the maximum heart rate)

>

> 5) Is sotalol generally administered in the hospital at first, or am I

> confused with something else?

Again I think that depends on what doctor you see and your own personal

history. I've heard reports from both sides of the coin.

all of the above is only my opinion. The best thing I can recommend is

to start your own research on all these topics.

http://www.affacts.org/

is a nice site to get started and if you don't mind some heavy reading a

lot of research can be found at PubMed...

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

Hope this helps, and good luck.

--

D

[Guest guest]

I don't know that there's any single best response on your questions.

Here's my take. I'm 46 YO male - also active w/kids. I was

diagnosed 22 years ago and have been on meds since, 3 ablations, and

considered/considering a PM.

On sotalol and metoprolol. (Was on dig plus other stuff in the past).

>

> 1) Talk to your doc about the pain/pressure. I've had some pain

over the years, never the kind that's talked about with heart attack.

Dizziness in A-fib for me usually means my bpm is up ~200 or more.

Your doc needs to know.

> 2) A-fib sure doesn't help your heart. This is another one for a

doc, I think - - especially since all our conditions have just enough

variation that comparisons get tough.

>

> 3) I've had three ablations - didn't work. One by a local doc, two

by a doc at Baylor med in Dallas. Long story why they tried 3 times.

For me, it was worth it just to know that I'd tried every

possibility. My only advice: find out who in your area is a leader,

has the most current equipment, does lots of the EP studies/ablations

and go with them if possible. Saves time.

>

> 4) I think this is different for everyone. Exercise puts me over

the top and into fib - or, if I'm in fib already, it makes my bpm go

nuts. I think that's the main reason I've liked sotalol. Despite the

side effects, I've been able to exercise while on it more than I had

in years on other meds.

>

> 5) My doc admitted me to the hospital when he first put me on

sotalol. Not sure if every doc does that.