Mondays with Morie—Episode 14a–Ablation Done!

Wow, that’s about all I can say. It’s over. I can’t remember if there ever was a time I had dreaded something so much for so long. I know a couple years ago I had to have dental surgery, which I put off for six months because I really, really didn’t want to do it or pay the $3,000 it was going to cost. But that was nothing compared to the anxiety and dread I’ve felt these last couple of months waiting for my ablation. The thought of being unconscious for four to eight hours was terrifying. I’m not sure why except that I’ve become somewhat of a control freak these last couple years. Maybe that happens with age.

Anyway, also being a compulsive “prior, proper, planning person” I made a list of all my financial information and even filed a “Beneficiary Deed” to my home. I just discovered the Beneficiary Deed by accident a couple months ago, and by filing this deed, it assures me that when I die, my house will pass to my children, by-passing Probate. I  had my daughter come over to the house to show her the file I’d prepared with all the information and her response was “I really don’t want to see this”. But hey, it’s part of life, and prior, proper, planning.

But…I digress. I got to the outpatient clinic yesterday morning at 7:00 a.m. and I was registered and taken back to the prep area within half an hour. Once back there, I had to strip down, except for my socks (thank goodness for that!) and put on one of those most attractive hospital gowns.  At least this gown fit a little better than the one I had the last time.20200107_075402Then on to the bed for a gazillion questions, vitals and starting the I.V. And although the nurse who put in the IV did a very good job of it, he placed it inside my right forearm and it hurt like hell. (Which it continued to do until it was taken out the next morning).

20200108_104551One of the routine prep tests is blood pressure. My first reading said my blood pressure was a whopping 191/101. I told the nurse that I had never had a reading that high; the highest ever being in the 170s. After some time, I became concerned that if this reading was wrong, it might cause things to be different once the procedures started. I told her I didn’t think that reading had been correct and I felt like the cuff hadn’t inflated properly. Thankfully, she said she would take another reading. She did, and it was back to a normal reading of 134/70. Whew. I was told they would not be making incisions in my groin, but instead, punctures.  I would have two on each side and they would be in my veins, not in my artery. I guess that makes sense since the veins take the blood back to the heart, sort of like a one-way street.

My husband came back to the room as soon as my IV was in and things then moved at a rapid pace. My nurse anesthetist came in and asked a bunch of questions. She told my husband that unless he really wanted to sit around for the next six hours, he could leave and they would call him every half an hour and give him an update on my progress. I told him to go ahead and go.  I surprised myself with being calm. I think the fact that the procedure was real and was really happening took away some of the anxiety. At just before 8:00 a.m. they began wheeling me to the cardiac cath lab for the Transesophageal Echocardiogram (TEE). It was about a half-hour ahead of time but they needed to sneak me in before the cardiologist started another procedure.

Heart.org describes the TEE which they use to check for blood clots as:

The Transesophageal Echocardiogram uses high-frequency sound waves (ultrasound) to make detailed pictures of your heart and the arteries that lead to and from it. The echo transducer that produces the sound waves for TEE is attached to a thin tube that passes through your mouth, down your throat and into your esophagus. Because the esophagus is so close to the upper chambers of the heart, very clear images of those heart structures and valves can be obtained.

The nurse had put my belongings in a tray under the bed, but I’d had my phone lying on my chest. When they placed another blanket on my chest, it covered my phone. When they wheeled me into the cardiac cath lab I decided I wanted to take one last photo. I picked up my phone and snapped this picture and the nurse anesthetist said with surprise “She still has her phone!” I felt like a kid getting caught doing something naughty. But, yea, I still got my photo. Needless to say, I was relieved of my phone and my glasses.

20200107_075824

The nurse anesthetist forgave my transgression and was very nice and explained everything to me. In preparation for the TEE, I had to gargle with some thick anesthetizing liquid which she explained I would need to then swallow. She said she’d be giving me some additional anesthesia in my IV but they would wake me up before starting the ablation so I could move to the table. This made me feel so much better; to know that when this first procedure was done, I would wake before I’d be totally put under. Shortly after I swallowed (and gagged) on the thick liquid she injected the anesthesia into the port in my IV and within about ten seconds I was out. She had told me earlier that some patients remember being woken up and moving to the table and some do not. I did not.

I don’t remember the recovery room and my first real memory is being up in my room and texting my husband at 3:20. I lost seven hours! My first text was

Screenshot_20200108-160028_Message+

I then sent a group text to my family members and it was even better, lol.

Screenshot_20200108-155940_Message+

I felt fine yesterday after the procedure, no pain or palpitations; I was able to eat a bit and drink just fine. The doctor said he’d been able to successfully ablate or as he described it, build a dam, around the pulmonary veins in the left atrium to treat the atrial fibrillation. When they were pulling the catheter from the left atrium into the right, he was able to ablate for the atrial flutter which he said most often comes from the right atrium. He said this side was a little more stubborn and once he had put my heart into atrial flutter, he found it a little more difficult to find the area he needed to ablade to stop it. He said he was finally able to stop the flutter by ablading between the two arteries? veins?

ablation
Washington Heart Rhythm Associates

The night was long and mostly sleepless. I still had my foley catheter in because I was getting Lasix to draw off the tons of fluids I was given during the ablation. In fact, when the doctor came in he said he’d given me 2500 ccs of fluid during the ablation and my output was 500 ccs so I still owed him 2000! When my night nurse came in she told me she would need to do an ECG around midnight and she would then take out my catheter. And by now I was ready to have it out. I really didn’t sleep before she came in and afterward slept fitfully until around 3 a.m. when I could have sworn they were having a party outside my door. I heard loud talking, some laughing, some groaning. Then it stopped. Then it started again. I really thought it was the nursing staff cutting up in the quiet of the night and I was stunned. So the cop in me took over and I decided to investigate. Wrapping my attractive gown around my rear end, I left my room and started down the hall. Two doors down, I looked into a room and saw three paramedics, one of which was probably the female I heard laughing. I later learned they were there because the large, deaf man in the room had gotten out of bed and tried to sit in the chair but missed and ended up on the floor. It was a party of sorts but not a fun one.

I don’t think I slept after that. I was in a lot of discomfort. My right shoulder, which I originally hurt while I was in the police academy over 30 years ago was aching and because of this, I had to keep my shoulder immobile. I was told the reason my shoulder was causing me pain was because my arms had been strapped straight out for all the time the ablation was being performed and my chest hurt which I knew was to be expected.

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Sunrise view from my window facing east toward the Missouri River

Finally, breakfast at 7. Never had coffee, even bad coffee, tasted so good. One thing about being on a cardiac diet in the hospital though is most of the food is awful. But I have to give a big kudos for their oatmeal raisin cookies, they are the best! It seemed like my room had a revolving door after that, my doctor, my nurse, a phlebotomist, a chaplain, a tech, a  caseworker, someone from a heart group.  I’d been told by the doctor after he’d seen me that he would put in my release order. Woohoo, but unfortunately shortly after that, my nurse came in with a two-hour bolus of magnesium. I was stuck for two more hours but  I was still out the door by 11:00 a.m.

I spent the rest of the day in my recliner.  My voice is pretty much gone and I don’t have any desire to eat. I’ve got two more medications which now brings my total to seven different meds for this Afib. But hopefully, according to the doctor, I should be off the meds, except for the blood thinner, within three or four months.

Update: 48 hours post-ablation and I felt as though my chest has been crushed. I can’t lie down, I can’t eat, swallow or breathe deeply. It started when I woke up that morning and continued to worsen as the day progressed. I spent the day sitting in my recliner watching television. One of the t.v. shows I always watch is “First 48”. I’ve seen so many episodes and have seen the grief of the spouses, siblings, and friends when they find out their loved one has been murdered. But today, I guess from the pain, when the victim’s sister fell screaming to the ground, I began to sob. I knew I needed to call the doctor to get some help with my pain.

The next day, miraculously, I was much, much better. The medication the doctor had prescribed the day before, the one he is hesitant to prescribe because of the common side effect—diarrhea, was true to its word. Luckily, short-lived but later in the day, I experienced two episodes of rapid heart rate; once up to 138 bpm. Again, the episodes did not last but about fifteen minutes each.
Saturday night the rapid heart rate returned and unfortunately has stayed that way until now (Monday afternoon).

From Debbe McCall on Facebook Atrial Fibrillation Support Forum:

The blanking (healing) period is 3-6 months after any ablation. Your heart has been burned/ablated without the benefit of burn cream, a bandage or even open to air to support healing. It takes time for your heart to heal and arrhythmias during the blanking period are normal).

I thought about calling the doctor’s exchange Sunday night but I was afraid that he’d send me to the emergency room. I don’t want to take that trip again; it costs lots of money and each time I’ve gone for an episode, I’ve been kept overnight. Finally this morning I called the EP’s office because my heart rate has been consistently between 110-130 bpm. He did what I thought he’d do and told me to come to the office and have an ECG done. My heart rate at the time was only 116 but the ECG determined I was in “Atrial Flutter with Variable AV Block”. Since this is a normal phenomenon of the blanking period, I’m not too worried. The only concern would be the longevity of it. From what I’ve read, I can be given more beta-blockers or if that would fail, another cardioversion.

Next week, hopefully, my husband and I will be back on track for an enjoyable Monday with Morie!

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