Jan 25, 2011

My atrial fibrillation adventure

(This post is a diary. For a summary and overview of my tachycardia and arrhythmia experiences see the October 13, 2013 post here: http://www.anti-itisdiet.blogspot.com/2013/10/tachycardia-arrhythmia.html)

This post is my "journal" for my most recent medical adventure, chronic atrial fibrillation. I will revise the post as events unfold. I am not asking for specific medical advice. I welcome any suggestions for topics that I should consider or reconsider.

CHRONOLOGY
1997: EPISODE OF AFIB. After a large dinner, I walked, stopped, bent over to retie my shoe laces -- and my heart began beating irregularly and about 170 beats per minute (as I heard later from the emergency medical technicians who examined me). A doctor in the emergency room administered a chemical intravenously. It restored the regular rate. I walked home from the hospital.

2010, Dec. 19-23: CHRONIC AFIB. After a large dinner, I experience a rapid, strong, and irregular heart rate. It continued that way, with some variation, for four days. (I have learned to avoid rushing into medical treatments.) At the end of that period, I called 911 because I was worried about the rate. The emergency technicians said it was spiking at about 170 beats per minute.

Chronic atrial fibrillation, in some forms, is dangerous long-term because of the possibility of (1) eventual deterioration of the heart muscles, and (2) stroke resulting from a blood clot forming in the atrium, being expelled into an artery, and then blocking an artery somewhere in the body. Besides the danger, "afib" is very uncomfortable in some forms and very distracting. (My productivity for any kind of intellectual work plunged.)

2010, Dec. 23-25: ER AND HOSPITALIZATION. I went to a local hospital's emergency room. The doctor in charge administered, through an intravenous tube, a drug designed to regulate the heart rate. It did not work. The medication did improve the beat regularity somewhat and did lower the rate to about 130 BPM. (A safe rate is less than 90 and an ideal rate is about 60 BPM.)

I was admitted to the hospital from the ER. I had tests of my heart (electrocardiogram and echocardiogram [ultrasound]), thyroid (no problem), lungs (CAT scan, no embolism), "heart protein" (meaning unclear, but no problem), blood (no problem with either fat levels or vitamin or mineral deficiencies). I also had no kidney or liver or other organ problems. (That was good news I attribute to my diet.) No one asked me about what I eat except that the hospital dietician asked if there are foods to which I am allergic.

Struggling against the standard hospital over-treatment, I rejected some of the drugs which hospitals automatically prescribe for every heart patient: stool softener (I eat a high-fiber diet!), antacid (I have had no acid reflux since adopting my "anti-itis" diet six years ago), pain reliever (I have had no chest pain), two of the three anticoagulants (I accepted only an aspirin daily). I did accept Metoprolol (which suppresses the rapid heart rate to a safe level) in the lowest dosage (12.5 mg, 2x daily). The official diagnosis was atrial fibrillation, with no identified cause. I was discharged on Dec. 25 with instructions to take Coumadin (Warfarin, an anticoagulant designed to reduce the chance of a blod clot forming in the atria).

2010, Dec. 26 - 2011, Jan. 1st week: OUT OF THE HOSPITAL: PHARMACEUTICALS. For about five days, I experienced oscillating mild chill and fever, but it faded away. I researched online for the nature and effects of Coumadin (Warfarin). I decided not to take it.

I was examined briefly by my new primary care physician, Dr. C, and he gave me a short list of local cardiologists. I found Dr. K, a non-intervention specialist. He prescribed a higher dose of Metoprolol, a beta-blocker, 35 mg, taken once daily in the morning with breakfast. (The lower dose that I had requested in the hospital, as a start, wasn't working when I was under stress -- e.g., in a doctor's office.) My Metoprolol is now a time-release medication; it works for 24 hours and is weakest at precisely the time of day when my heart rate is naturally lowest, thus avoiding the danger of over-medicating and slowing the heart rate too much.

Dr. K discontinued my aspirin. He prescribed Digoxin, another beta-blocker designed to suppress heart beat. Dr. K also prescribed a drug newly "approved" in the USA, Pradaxa, an anti-coagulant. He gave me enough free drug samples of the Pradaxa (normally about $250/month), to last me until a stress test in his office. At that point, Dr. K said, he might be able to offer a more definitive diagnosis and recommend either a treatment program (possibly continuing the Pradaxa) or acceptance that I will need to live with the problem and continue taking Metoprolol and Digoxin to suppress the racing heart.

Dr. K confirmed what I had read about risk. The hospital doctors told me that I was at "high risk" of stroke, but I found later (and confirmed by my cardiologist) that the actual risk of stroke for a 66 year old man with afib, without medication, is, say, only about a 2% chance per year. With medication, it drops to about 1% per year. (The exact numbers are unclear to me.) So, relatively there is a much higher risk (100%) of stroke with not taking an anticoagulant, but the absolute level of risk is fairly small. On the "CHADS" scoring system (0 for the lowest risk, 6 for the highest risk), I am in the 0 category. As usual, the hospital doctors were being (over) cautious, perhaps for legal or regulatory reasons as well as training.

The pharmaceuticals I am taking now (Metoprolol, Digoxin, and Pradaxa) caused diarrhea in the first week. That problem lessened after about five days and then ceased when I began adding a probiotic (over the counter, chewable tablet, one per meal, containing Lactobacillus Acidophilus and L. Bifidus). I take all medications in the middle of meals, but spaced apart.

I am taking at meals two nutraceuticals -- nonprescription nutritional supplements designed to address specific problems -- recommended by two cardio physicians whose books I have read (with serious doubts, in one case): cod liver oil (1 teaspoon/meal), Vitamin B12 (50 mcg, 2 x week), and magnesium oxide/gluconate (1/day, 250 mg, which is about 63% of the Recommended Daily Allowance). The largest sources of magnesium are animal products and "seeds" (grains, and so forth). I can eat no animal products (except fats) or "seeds" without bringing my "-itis" problems back. (See "Key Posts" in the upper right corner.)

Three circumstances now accelerate my heart rate disturbingly: sitting up or standing up too quickly; compression (for exmple, bending over to tie my shoelaces); and mental stress (for example, reading the news). Mental stress is the strongest cause and the most difficult for me to control, but I am learning. My quality of life might depend on it.

GENERAL OUTLOOK: As of Jan. 25, a month after leaving the hospital, I have fully recovered my strong appetite, energy level, and exercise schedule (light weights, stretching, and walking 2 hours/day). Although I don't expect to live as long as I had originally hoped (85), I am cautiously hopeful that I can continue to live well for more years without yet starting to slide down the pharmaceutical spiral of ever-more drugs that treat the destructive effects of earlier drugs. I have no fear of death or of dying. I hate the idea of becoming progressively sicker because of pharmaceuticals.

UPDATE, 2011, Jan. 31, 10 am stress test: I took the stress test and enjoyed it. The main conclusions Dr. K reached are: (1) I have no heart problems other than the atrial fibrillation, and even that is not major; my heart efficiency is low but not dangerously so. (2) The Metoprolol and Digoxin are indeed suppressing my heart rate. (3) I need to continue the anti-coagulant Pradaxa until I can make a decision (after one more tests in three weeks) whether to have cardioversion or continue with some combination of drugs. (4) I probably will be able to replace the Pradaxa with a daily aspirin, eventually. (5) I am still in the bottom, least-risk category of the ranking for stroke risk. (That is why an aspirin will be sufficient, long-term.)

The details are, so far, unclear, but apparently the next step is to begin an additional drug for a few weeks, and then I will have another EKG. Apparently the new drug is a mild form of cardio-version (turning the irregular heart beat back to normal) that is safe for outpatient use. (More serious electrical, chemical, or surgical cardio-version would require hospitalization because of the doctors' fear of a stroke from a blood clot released during the cardio-version process. Apparently, when I begin the new drug, I will continue taking the Digoxin and Metoprolol but at reduced levels. I may have more details after February 2.

UPDATE, Jan. 31, 5 pm and 11 pm: While preparing dinner, I injured one finger with a tiny cut. It bled a small amount, but continuously for 30 minutes, despite soaking in cold water and wrapping it in tissue.

UPDATE, Feb. 4: Today I received my new instructions, via my doctor's medical assistant/nurse. I will continue taking Metoprolol (1/day, but now at 25 mg, half the previous daily dose), for rate control, and Pradaxa (2/day), for anticoagulation. Replacing the Digoxin will be Multaq (dranedarone), 400 mg/tablet (2/day), for rhythm control, as a sort of out-patient cardioversion, apparently. I am also continuing my nutraceuticals: probiotic (1/2 per meal), magnesium (250 mg, 1/day), cod liver oil (1 t, 3/day), and B12 (50 mg, 2/week). I am scheduled for an EKG in my doctor's office on Feb. 17.

I have a growing list of questions about the drugs, especially the Multaq: what are its advantages over its competitors? Safer? More effective? Only one governmentally approved for outpatient cardioversion (as my doctor had suggested in the past)?

UPDATE, Feb. 17: An EKG in my doctor's office revealed that I do indeed still have atrial fibrillation and my heart rate, even under medication, remains high (78 bpm). The chemical treatment (Metoprolol, Multaq), which is therapy stage 1, failed to reset my heart rhythm or lower the rate enough.

I agree with my doctor that trying the next stage of therapy, stage 2, is worthwhile, though it is expensive and has a success rate of only about 65% of the cases. This stage 2 is "cardioversion," in which I will be sedated at the hospital and then given a painless shock to my heart. The purpose is mainly to restore proper rhythm, apparently. I don't know whether lowering the rate is also a goal of cardioversion. The brochure I received from my doctor speaks only of rhythm restoration. My understanding though is that if the rhythm is proper, the rate will follow naturally. (I will need to double-check that.)

If the treatment does not work, or if it works only for a few months, I will not repeat it. (The success rate of repeated treatment is very low.) Instead, I will use only one drug, Metoprolol (plus an aspirin as the anti-coagulant), to fully control the heart rate and thereby make the heart more efficient. This approach is similar to the one Dr. McDougall describes in his newsletter article on Coumadin: Suppress the high heart rate (which functionally is the key problem) and live with it.

UPDATE, Feb. 24: Today I had the cardioversion therapy. It worked! My heart is now back in a normal rhythm and rate range. The procedure was painless, thanks to the intravenous sedation. If you have the procedure done, don't drive or make any important decisions afterward! I could barely form a complete sentence. I came home and slept for three hours.

My doctor convinced me that, on the short-term, I need to continue the drugs in order to keep my heart in a narrow range of rate (Metoprolol) and rhythm (Multaq), as well as to protect myself from a clot expelled by my now more effective heart (Pradaxa).

UPDATE, March 8: I consulted with my cardiologist today. Here is the plan: (1) Stop taking Pradaxa, the anticoagulant. (Drop from two doses daily to 1 dose daily, for 3 days, then stop altogether.) (2) For the rest of my life, take an 81 mg aspirin tablet daily as an anticoagulant. (3) Stop taking the Multaq after one more week. (4) For the rest of my life, take Metoprolol, 50 mg, time release, every morning, to keep the heart beating in a low range, thus avoiding a higher range that might send it into fibrillation again. The two usual causes of returning to afib are: drinking alcohol and general anesthesia for surgery.

I have hired a nurse-researcher to help me gather information about metoprolol: What are the risks of long-term usage? (My doctor says there are no established cumulative adverse effects.)

UPDATE, March 19: I have returned to normal, almost. I am walking as quickly (3 mph) and as far (5-6 miles/day) now as I did before the afib episode. I have stopped taking the daily aspirin. I do not need any anti-coagulant, either in general or in particular for the former afib problem. Now I am taking only the Metoprolol, 50 mg, a low dosage, but one high enough to make me drowsy two hours after swallowing it with breakfast. I am considering experimenting with a half-dose. I am continuing to take 1 teaspoon of cod liver oil per meal, one magnesium tablet (250 mg, 60% of RDA) per day, and two 50 microgram Vit. B12 tablets per week. The oil and magnesium are recommended by some cardiologists, though in much higher doses than I am taking. I am also continuing to take half a probiotic wafer per meal.

UPDATE, May 5: I now take 25 mg of Metoprolol. (I am cutting the regular tablets in half.) I take no other medications: no aspirin, no magnesium, and no cod liver oil. I continue to take a probiotic and a Vitamin B12 tablet (50 micrograms twice weekly).

UPDATE, August 26: Yesterday I stopped taking the Metoprolol. My mood is more positive; food transit time is a little faster; and I am much less drowsy. My blood pressure and heart rate have risen (about 10/10 and 10, respectively). That increase -- if it goes no higher -- is not alarming, but it is worth watching.

UPDATE, April 24, 2012: In March, 2012, I went back into afib. The cardioversion worked for one year. I do not know what caused recurrence. In a local emergency room, the physician said I was dehydrated and "moderately low" anemic. The hospital found no other possible causes (as in the previous episode). I never noticed being particularly thirsty. Now I am wrestling again with trying to decide what to do: Continue with medication (Metoprolol, 50 mg) to control the rate (about 130 bpm without medication, about 80 with medication) and blood pressure (about 125/80 with, 150/90 without)? Or try cardioversion again, and if that doesn't work, try more invasive procedures? This time, I may choose to take the medication and just live (or die) with it. I will write more after I resolve some of the many issues.

UPDATE, September 15, 2012: After taking 50 mg of Metoprolol daily April-July, and after refusing a second cardioversion, my heart has returned to normal sinus rhythm. My physician confirmed that a few days ago, while I was taking 25 mg of Metoprolol. (Because my heart rate has been dropping as low as the 40s, I have begun taking 12.5 mg, half a 25 mg tablet.) I probably will continue the Metoprolol. I am monitoring my heart rate and blood pressure. I have discussed the possibility of substituting digoxin, but my physician and I have not yet made a decision. Possible causes of a return to normal rhythm are: (1) an increased dosage of Vitamin B12 (from c. 250 to 1250 micrograms/week) in the two weeks before; and (2) resumption of using salt (containing iodine). The afib has disappeared as "spontaneously" as it had appeared.

Burgess Laughlin
Author of The Power and the Glory: The Key Ideas and Crusading Lives of Eight Debaters of Reason vs. Faith

19 comments:

Brian said...

Omega-3 fish oil reduces the risk of atrial fibrillation. You might try a consultation with this doc:

http://heartscanblog.blogspot.com/2007/01/fish-oil-and-perverse-logic-of.html
http://heartscanblog.blogspot.com/2008/04/warfarin-is-scary-stuff.html

Burgess Laughlin said...

Thank you for the suggested link. I do read that weblog regularly, though not usually in depth. I often disagree with the author's suggestions as they apply to me as a unique individual. Nevertheless, I find his arguments engaging and I do pay attention to them.

I have decided to consume cod liver oil (in the pourable form, so I won't choke on a mis-swallowed gel capsule!). Normally I avoid animal fats. (I am not convinced there are any "good" fats in isolated form.) The amount here is small. In this case, based on the little I know, the risk of taking such a small quantity seems to be much less than the potential rewards claimed by its advocates.

I am open to discussion and alternatives on this issue.

Burgess Laughlin said...

As of March 30, 2011, I am taking 1 teaspoon (5 ml) of cod liver oil per meal, three meals per day.

This source discusses cod liver oil: rxlist.com/cod_liver_oil-page3/supplements.htm

Cod liver oil is the only anti-coagulant that I am taking. (I stopped taking the aspirin, as unnecessary.) I really do not need an anti-coagulant. The CDO may provide other benefits. That is why I am taking it.

Burgess Laughlin said...

CORRECTION
The "CDO" in my previous comment should be CLO.

WHY COD LIVER OIL RATHER THAN OTHER FISH OIL?
This article suggests cod liver oil rather than other fish oils.

thehealthyskeptic.org/when-it-comes-to-fish-oil-more-is-not-better

Anonymous said...

Joe Baker

Hi. I'm surprised that you take a tablespoon of cod liver oil with every meal. Whether that means 3 or 4 tablespoons per day that is one hell of a lot of oil in what otherwise sounds like a low-fat vegan diet. There are several of Dr McDougall's fans (I am one, by the way) who have seen their fibrilation problems evaporate with good compliance to a low-fat vegan diet. Personally, I would not dream of taking cod or any other oil on a regular basis as a medication - if at all. Surely a 75mg aspirin is a much safer bet? Best Wishes

Joe Baker
London

Burgess Laughlin said...

First, I am not a vegan. I reject veganism. As it has been presented to me, it is a mystical ideology or possibly a worldview. It has no basis in reality, logic, or reason.

Second, how would taking aspirin provide Omega 3's or Vitamin D? (I am not taking cod liver oil as a "blood thinner.")

Third, consider the facts. I now take 1 teaspoon (not tablespoon) of cod liver oil once or twice a day. I often forget to take it. See the "What do I eat now?" post (link provided in the Key Posts list near the upper right corner.

Fourth, a very low fat (less than 10% of calories from fat), all plant foods diet is what I was eating -- and had been eating for eight years -- when I had the recent episode of atrial fibrillation (the second in 15 years). Eating only plant foods, in 100% healthy combination, didn't save me from the onset of afib. Continuing to eat a healthy diet, in 100% compliance, did not stop the afib once it started. Cardioversion (electrical) stopped the afib.

Fifth, I live in a very dark part of the world, here on the Olympic Peninsula of the USA. Vitamin D is hard to obtain from sunlight. Omega 3's are also difficult for me to obtain. (I can eat no flax seeds, for example.)

Sixth, I began adding the cod liver oil at a time when my Body Mass Index had dropped to about 16.9, which was too low. Now, finally, it is up to about 18.

I am open to eliminating the cod liver oil if I can find alternative sources of Omega 3's and Vitamin D -- from low sulphur sources. (See the November 29, 2011 post, "Low Sulphur Experiment is Successful.")

If I am missing information or if I have misunderstood any point, I welcome education.

Anonymous said...

Joe Baker

I accept your dislike of the term 'vegan' - it does have negative connatations! Apologies for any mistakes I made with regard to your regimen. You are obviously well-motivated and have done your homework! Your approach sounds similar to that described in one of th excellent Vaughns one-pagers: http://www.vaughns-1-pagers.com/medicine/a-fib.htm
Forgive me if this is not the case.
Are you aware of the potential negative links between vitamin D supplementation and arterial fibrillation? Best Wishes and thanks for the speedy pick-up?

http://www.webmd.boots.com/heartdisease/news/20111118/high-vitamin-d-levels-linked-to-heart-condition

Joe Baker

London

Burgess Laughlin said...

I have seen press reports of the article supposedly linking Vitamin D and atrial fibrillation. My newsfeed selects articles for keywords such as "atrial fibrillation" and "Metoprolol," the medication I was taking (but no more!).

I note the pubmed article offers these cautions about the report:

This study was presented at a medical conference rather than published in a medical journal. That means it hasn’t been checked by journal reviewers, and we can’t look at the study in detail. So, we can’t assess the reliability of the research in the same way we would for a published paper.

However, it’s worth noting that this type of study can’t prove that high levels of vitamin D led to atrial fibrillation. It can only show that there may be a link, which could be caused by other factors. For example, some people with high levels of vitamin D might have been taking supplements because they were in poor health and had other problems that increased their risk of atrial fibrillation, such as high blood pressure.


Another point I would offer is that recent blood analysis indicates that I am "in range" on all nutrients, including Vitamin D. In other words, I do not show a high level of Vitamin D despite taking a supplement. That suggests to me that without the supplement, my Vit D level is probably low. (Of course, I am assuming that the cod liver oil is actually working.)

A third point is that the pubmed article shows that though the relative risk of taking CLO is twice as high, the absolute risk per year (12 months) is fairly low, apparently only about three percent (adjusted from the 20 months the researchers used).

I would love to delete the CLO, if for no other reason than to simplify my life further. For the time being, I will continue it. Perhaps I will discontinue it during the lighter months of the year.

I am grateful for the link. I will continue to evaluate the CLO.

Burgess Laughlin said...

I examined the first paragraphs of the linked Vaugn's Summaries. It does not apply to me. He says, if I understood him correctly, that he had no tachycardia.

I did, ranging from 130-170 beats per minute. That combined with fibrillation and irregular beats was scary. Having no treatment was not an option. I could not function well physically and could barely function mentally at all. The distraction was heavy.

Again, thank you for the suggestions. They have led me to reconsider the CLO.

Burgess Laughlin said...

BTW, I noticed in skimming one of the Vaughn's Summaries boxes that the author takes fish oil as well as a bunch of other supplements.

Burgess Laughlin said...

A site that helps in understanding afib and how to treat it is:

http://www.stopafib.org/

The site has a "tree" in the upper right corner of the home page. The items on that tree can help decide how much risk is involved and what escalator of treatment is available: ranging from treatment with drugs (in various numbers and levels of intensity), electrical cardioversion, and surgical cardioversion.

Burgess Laughlin said...

Over the last 10 years or so, I have -- at three different times -- used fish oil. In everyone of those periods, I have had a hemorrhage in one eye or the other.

I did not recall this pattern until recently, when I looked at some of my notes. Of course this could be a coincidence, but I doubt it. Fish oil can for some be a powerful anticoagulant. Be very cautious.

I will not use fish oil again. The last hemorrhage I had, in 2011, was very scary and potentially destructive.

Dr. John A. McDougall's general advice to not use any supplements unless there is a specific, proven, individual reason, is sound advice. I will follow it.

Anonymous said...

Question: Do you have sleep apnea? I started atrial fib when I was running and my resting heart rate fell below 40 beats per minute (and yes, I was running a lot!). I was slim, in great shape, but would have dreams of not being able to breathe. A similar experience of medications and cardioversions followed, with a diagnosis of "lone atrial fib". Fast forward 20 years, I had to have my right hip replaced. I was asked about sleep apnea, had a sleep study and was given a cpap machine. That was 19 months ago. I'd had a history of 4 - 6 cardioversions per year. I've not had an incident of atrial fib since the cpap machine arrived. Sleep apnea puts undue stress on the heart, etc.. Perhaps this is something that may apply to you and you might want to pursue. I am a 60 year old male.
JLeavitt

John Bedson said...

You have vagal afib and the Digoxin and Metropolol will have made things worse. Multaq is too weak to help you. You should try Flecainide with a rate control of Verapamil. However your treatment has been so awful that it is likely that your atria has electrically remodelled during your prolonged time in afib and getting it under control may be impossible. Email me: bedson@pacific.net.au if you need more help and advice. I'm not willing to discuss here; but I am willing to try to help you. Best regards, John Bedson.

Burgess Laughlin said...

Mr. Bedson added his comment not realizing that I have returned to normal rhythm. I had failed to add an update about that return to normal rhythm. I have now done so.

Tracy said...

How bad is the drowsiness with Metoprolol 12.5? That's what they want to start me on (I'm a 44-year old female and I need to be able to think clearly and drive). I'm afraid to take it.

Burgess Laughlin said...

My experience with Metoprolol (time release) at a dosage of 12.5 milligrams is this:

1. I take it, as directed, at breakfast. I do sometimes experience drowsiness an hour or two after breakfast. At other times, I don't experience drowsiness. The difference between one morning and the next seems to be the nature of what I am doing (as well as how much sleep I had). If the activity is demanding, I hardly notice the drowsiness. If it is very boring (such as proof reading a text or reading the history of medieval theology), then the drowsiness is so deep I can't function mentally.

2. Note, however, that I sometimes experienced the same symptoms even before I started taking Metoprolol. I have sometimes experienced drowsiness after breakfast -- going back decades. The drowsiness might also be a function of how much I eat. I eat very large meals, with no snacks between meals. A lighter main meal might produce less drowsiness. Of course, you need to make sure you are eating a meal large enough to "cover" the drug (to protect your gut).

3. When I was taking 50 mg, I was not four times more drowsy, but I was a little more drowsy. In other words, the relationship for me was not a direct one between dose and drowsiness. At 12.5 mg, I have no trouble walking and paying attention to traffic signals. (I don't drive.)

You might experiement on a Saturday (if you have a weekend off).

These suggestions are simply based on my experience. They are not medical advice.

Gregory King said...

Hello Mr. Laughlin and thank you so much for sharing your experiences. You show an amazing (and as it relates to my abilities; enviable) ability to organize your self managed healthcare program. I found from reading this blog that I had been lying to myself in regard to my efforts to live healthier.

Unfortunately of the cardio care 'professionals' I have seen found them to be resistant to my attempts to partner with me. Seemingly my participation is confined to check writing.
I'm a 55 year old man, have a physically demanding job, and have dealing with afib since Dec. of 2007. It's kind of a 'where were you when JFK was shot' thing...you never forget what you were doing. In my case I was getting ready for bed. Hindsight being what it is, I've been forced to admit that I more or less asked for afib in that I took horrendous care of myself for many years. I have past heavy recreational use of stimulants (late teen and early adulthood), anxiety/depression onset in 1986 (I'm not a candidate for mainstream medications due to a weird backward metabolism), a divorce, I had a stressful job, drank too much, ate poorly, smoked 3 packs a day, a marriage, have sleep apnea (still no cpap commitment), and was dealing with the teen suicide death of one of our daughters in 2000.
ER administered nitro and an antiarrythmic that first time. Immediately following, and for the next 6 years, until this year, my family doctor treated me with atenelol and Warfarin. I quit drinking except for a very rare social drink or two, cut my smoking my 2/3's (I know...sigh... I'm trying), I watch my carbs, 'try' to eat healthier and get a pretty good physical workout from my job.
Recently however I ended up back in the ER for an afib episode that was stubborn and looked as though it would resist chemical conversion with amiodorone. Just before I was scheduled to undergo electro-conversion I converted. As my family doctor had just retired I didn't have a primary care to guide me. An on-call preventative cardiologist (huh?) came in my hospital room and after finding out I didn't have a dedicate cardiologist told me he'd be my doctor. (He could have been a janitor for all I knew!) I figured, what the heck; I need somebody to immediately guide me while I looked for a new primary care doc.
Long story short (yeah, ummm, sorry about that) he's taken me off of the atenelol and prevastatin (cholesterol med he says I didn't need), and put me on a pill form of amiodarone as well as minimally increased my Warfarin. I've been researching the side effects and dangers of amiodarone and I gotta tell you, I am flat out scared! He jumped from a low key treatment I was on to an organ killing toxic poison! He still has me on the front end loading dose of 400 mg/day! This is the threshold at which really bad things can start going wrong with my liver, lungs, eyesight, and other bits of me that are currently very healthy.
In the interim to finding his replacement I'm trying to get him to return my calls to initially address the high dosage, and now having read the posts here, investigate metoprolol as a replacement for the rat poison he has me on now.
I'm angry and upset he prescribed a last line of defense med for someone such as myself. Someone who has no other heart or medical problems. He hadn't even begun to rule out less harmful meds bwfore resorting to one that hasn't even been approved by the FDA for treatment of afib!
If anything, my addition to this thread should serve as a warning to others. Educate yourselves. Find that doctor who will let you participate. And most importantly as I've learned; take preventative steps and don't wait and blame someone else when you aren't cared for as selfishly as you would treat yourself.

Burgess Laughlin said...

Gregory, thank you for your testimonial. I wish you well in your movement toward healthier living. I hope you will consider a healthy diet. Here is what I suggest: http://www.anti-itisdiet.blogspot.com/2013/10/the-way-of-eating-i-recommend.html

Here is my summary of my afib experience: http://www.anti-itisdiet.blogspot.com/2013/10/tachycardia-arrhythmia.html

By the way, I no longer use fish oil in any form. I have had three hemorrhages in my eyes in the last 10 years, always at the times when I was using fish oil. It is a powerful anticoagulant that I now avoid.