Atrial Fibrillation: Pardon My Fib

Afib personal story
How do you talk about having Afib?
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Normally, learning a word gives me joy. For example, I recently came across the word "panache" while reading about a World War I general. I stored it away, thinking, perhaps I'll be reaching for a word one day and panache will be just the ticket. For example, "Wow, you're spreading that mayonnaise with real panache!"

 Fibrillation, on the other hand, is a word I'd just as soon not know. I'd also like to toss out a whole slew of terms I've learned in association with it: Afib, both brady and tachy- cardia, the anatomy of the heart, all the acronyms and medications and risks, the whole gambit.

“Afib?” I’d say with a shrug, “Never heard of it.”

I've learned to live with Afib. I've adapted my lifestyle to avoid triggers like cliff diving. My perception of atrial fibrillation has even evolved from one of villain to an unpleasant but necessary reality of life, like traffic. I’ve even experienced a benefit from Afib.

Yet, the one thing I've never really learned is how to apologize for it.

 I had my first Afib episode in March of 2006 from a virus I caught while traveling to Arizona with my girlfriend Megan and her family. Since then, it's happened to me five more times for a total of six episodes. What follows are scenes from the whole saga, Star Wars style.

EPISODE I:  The Phantom Fib Menace

“It was some virus,” I told Larry from my old man basketball pick-up game. “The skin on my palms and thighs burst.”

"Oh!" he said, "That's nasty."  

"I know, I know,” I said, nodding and soaking up the sympathy. “It really was."                                                

Then one night I started getting a little paranoid when I felt like my heart wasn't beating right. My friend Tex, a real opportunist, seized on Manny holding my wrist and taking my pulse.

"Hey, since you two are holding hands, why not go for a stroll?"  

and,

“If the music is too fast, I could put on something slower."  

Manny, a psychology student with a basic knowledge of heart rates, couldn't count the erratic beats. "I don't know Timmy," he said, a little worried. "I think something is off."  We held hands for quite a while, until Tex finally told us to get a room.

My doctor put me on Warfarin, which my 86-year-old grandfather was on too. I imagined the end of a drug commercial where the grandfather and grandson each take their pill, embrace, and as the grandfather tussles the grandson's hair, the wide-eyed grandson asks timidly, "Now both our blood will be thin?"  The grandfather responds wisely, with a twinkle in his eye, "It's the same blood."  And the family gathers around and laughs as the commercial fades.

I got cardioverted. I woke up after the shock and presto!  Good as new. And for the first time I found myself explaining Afib to my friends, my Department chair, to the old men in our basketball game, and a few others. I was trying the new vocabulary out like someone studying French for a vacation.

“Afib is not life threatening in and of itself,” I told Larry after the cardioversion. “When the atria are quivering they slosh blood around, which can form a clot.”

“Oh, that does sound dangerous.”

We shared a sigh, like a storm had passed with no harm done.

Then we nodded at the marvel of modern medicine.         

“Isn't science amazing?”

Episode II:  Attack of the Fib Clone

I was working out. The next thing I knew I was lying on a bench in the locker room of a 24-Hour Fitness trying to slow my heart down, taking long, deep breaths full of locker room Joxygen.

The nurse I called didn't mince words.

"Hang-up the phone. Drive to the ER."

I stayed in the hospital overnight and missed a concert. There was no shock. This time they did the cardioversion with drugs.

"Enjoy the show everyone,” I texted. “I have a little heart issue to take care of. Nothing serious.”

“We miss you! Feel better!”

“You have to exercise,” my cardiologist said a week later. “Maybe cut back on coffee.”

No coffee! A missed concert! Afib began to assume the shape of a villain in my mind.

EPISODE III:  Revenge of the Fib

A few months later, I moved from Chicago to Southern California. I was moving into uncertainty.  I had to find a job and a cardiologist.

I went for a swim one Friday afternoon in the unheated pool of my apartment complex.

Getting out, I felt once again a dreadful pang of anxiety. Is my heart beating correctly? The villain had struck. I called Megan. It was time to go to the hospital. Before leaving, I had to call Byron, my future brother-in-law.

"Hey Byron."

"What's up?"

"I'm not going to make golf tomorrow morning."

"Oh yeah?" a tad skeptical.

"Yeah. Sorry to have to cancel last minute. My heart's in an irregular rhythm so I have to go get it checked out."

"Oh?"

"I don't think it's serious. It's something I've had before, but I have to go to the hospital."

The day after I cardioverted was Megan’s friend Christie’s boyfriend Mike’s birthday party. There was a party at his apartment followed by a local concert that night.

 “You don’t have to go if you want to take it easy,” Megan said.

“I’ve laid around enough,” I said. “I’m not going to let Afib keep me from living my life.” Afib was now more than a villain. It had become like a terrorist, acting without logic or compassion.

So, we went. I was the only sober one there. Mike was an offensive lineman in college and a lot of his college friends were in town. It was his thirtieth birthday. They had a keg and things were picking up just as we arrived. It seemed like the whole line was together again and they all had nicknames. They were reliving a time when they had ridden a canoe down a hill in college.

“Hey guys,” Christie, not one to be discreet, sang out. “My friend Megan and her boyfriend Tim are here. Tim spent the night in the hospital.”

 So, I followed their story with my own.

“It started when I got a virus in Arizona….”  

Once the air was completely out of the party, there was nothing to do but ask for ice water and nod along to, “Wow man, that’s crazy.”

Later, we went to see a local band. I was regarded as something of a trooper or good luck charm. I was the guy hanging out with some kind of heart thing. I felt like the quarterback at practice, wearing a red mesh jersey so no one would tackle me, walking around with my offensive line.

The pattern would repeat itself three more times: A-fib, apology, cardioversion.

Episode IV:   Not Really New Hope

I got Afib at Manny’s surprise 30th birthday party after trying unsuccessfully to pee in a sixty-degree lake.

“You’re not going to die, are you?” Debra, his wife’s best friend asked me.

The aftermath also featured this conversation with Manny’s wife’s older sister Mary, an ER Doc.

“Hi Tim, it’s Mary. How are you feeling?”      

We talked for about five minutes. “It started in Arizona…” She spoke in a very prudent, I-don’t-really-know-you-and-I’m-not-your-doctor-and-I-can’t-be-held-liable-for-anything-I-tell-you-so-you-should-probably-just-go-to-the-hospital tone.

“It sounds like you’ve been through it before,” she said neutrally. It was like the nurse the day of Lollapalooza. All they can say is, go to the hospital.              

Episode V:  The Fibrillation Strikes Back

Afib killed my dream of becoming a physician assistant, and I’ll forever be grateful.

In many ways, it was becoming abundantly clear that becoming a PA wasn’t the right thing for me. I had tried to convince myself for so long, that I didn’t want to admit the obvious.

Enter Afib.

We were playing a pick-up game of basketball before a pharmacology class on arrhythmias. My heart was racing. It didn’t slow down. I went to class. The lecture started. It still didn’t slow down. I left class. Another professor took me into his office and listened to my heart with his stethoscope. “Wow, you’re really going,” he said. They called an ambulance. My classmate showed up at the ER. My heart slowed down into Afib. We waited and ordered Chinese food. The doctor joked that the egg rolls might convert me. But they didn’t. I had to be electrocardioverted the next day. It was in front of a whole crowd of students. My arms flopped like a fish out of water. He had to zap me four times. If the last one didn’t work, he wouldn’t have tried a fifth time. It did work.  I went home. A week later I left PA school.

 Episode VI:  Return of the Fib

I went into Afib while running up a steep hill.

Megan drove me to the hospital and a nurse shaved off the tarantula patches of hair on my chest.  Ten minutes later, an anesthesiologist was in the room preparing the sedative. A creamy white liquid dripped down my IV.

“It’s the same sedative that killed Michael Jackson,” he said matter-of-factly. Then he smiled, realizing that this wasn’t the best subject for small talk.

The drug went to work. I was very happy for a few moments, almost euphoric.

Then I was very groggy and before I knew it, I was awake and it was over. I had cardioverted. I was in a regular rhythm again. Megan came in, along with the smiling nurse for one more EKG.

“You were really rocking the Michael Jackson,” she said.

I went to see my new cardiologist. His advice was that I start taking a medicine to prevent a-fib, three times a day. I had some reservations about being on a heart medicine full-time, at the age of thirty-two. On the other hand, I also was getting tired of visiting the ER.

I surrendered. To a drug called propafenone.

If Afib is a terrorist, then my medication is the TSA. Every eight hours a new watch begins, and they check each day’s moments like they’re pockets, backpacks, suitcases, and shoes. I haven’t had another episode since then, knock on wood.      

On the first Monday back I went to tell my principal about what had happened. I figured some face-to-face details would assure him that I had not skipped out on the last day of school before break. I was a temporary teacher on a one-year contract, a yes-man on eggshells. I didn’t want to go back to subbing. We had a mortgage. We had health insurance. I didn’t know it at the time, but we had a baby on the way.

I caught him during the morning snack, practically chasing him down.

“Everything is O.K. now, Herb,” I told him as he continued walking.

 “Good, good,” he said.

I took him through it, the triggers, the way the atria quiver above the ventricles. Then, right before I got to Lake Geneva, he saw a student he needed to talk to.

“I don’t anticipate missing any more days this year for this condition,” I called after him. “I’m hoping the medicine I’m on will be preventative.”  He practically had his back to me, turning more out of surprise that I was still talking.

“So I’m good to go,” I summarized.

 “That’s great, Tim,” he turned to say. “Glad it was nothing serious.”

I’m still sensitive about my heart rate. I’ll feel my pulse after feeling a strong beat or a palpitation, which I get from time to time. I’m told they’re normal and happen to everyone. My paranoia is like a threat level and has been on low for some time.

The medicine quickly became part of my routine, like dental hygiene. I take it when I wake up, at two in the afternoon, and before I go to bed. It’s like I live my life eight hours at a time.

I visit my cardiologist once a year. I drop in, we shake hands, he fills my prescription and says see you next year.

Megan is always writing thank you cards. Sometimes this means I have to write one. So, if I were to write a thank you note to Afib, it would go like this:

Thank you Afib. You are a terrorist and you have wreaked havoc on my life. I missed Jay’s birthday dinner and Pearl Jam at Lollapalooza because of you. You lurked in the shadows of my late 20’s and my 30’s and I hated you. I hated your indiscriminate attacks on my life. For years, I would anxiously feel my pulse. I blame not learning to surf on you. I hated that you could hijack my day.

But I am in debt to you, masked villain. I owe you my sincere appreciation. You made it okay for me to quit PA school. You were a blessing in disguise. You gave me a way out. Thank you Afib. You killed my dream and saved my life.

It’s only now that I’ve written about it, Star Wars style, the complete six episodes like one long saga, that I realize there’s nothing to be sorry about. So, if my next episode happens at your birthday party or at a dinner at your house, I won’t even bother to explain it all.

“It’s Afib,” I’ll say like I’m referring to an old friend, “an irregular heartbeat that visits me from time to time.”

That way, I can exit the party with some real panache.

 

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