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JZ
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| Quote: | Originally posted by EnsenadaDr
OK...let's get to the bottom of all of this. Before I became a doctor in Mexico, I worked 15 years on the telemetry floor (the heart monitor floor)
in different hospitals from New Jersey to Florida to California to Hawaii, as a Registered Nurse. Atrial Fibrillation is a conduction problem, which
can be controlled with medications. When the medications don't work, the Doctors will try Cardioversion. This works especially with new onset AFib.
But sometimes the Cardioversion doesn't work, and the person reverses back into atrial fibrillation. AFib, in itself, is not dangerous. What is
dangerous is that if the blood is not "thin" enough, the person can throw clots because the atria starts fibrillating, which can cause stasis of the
blood and can cause clots. Now, ablation is a whole other ball of wax. Ablation is done only when medications and cardioversion doesn't work. It
usually is done for a condition called SVT, or supraventricular tachycardia. This usually means the heart is beating at over 200 beats per minute,
and if unchecked, it will go into a fatal rhythm called ventricular tachycardia. VTach can lead to death. If a person has several episodes of SVT,
and cannot be controlled with a calcium channel blocker or anti-arrythmia drug such as Amiodarone, the Cardiologists will send you to a specialist in
Cardiology (an electrophysiologist) that studies the electrical system of the heart. They will actually try and put your heart into the abnormal
rhythm and with the use of computerized mapping, will see the location of where the abnormality is, and will cauterize that part of the heart.
Ablation is not something that should be taken lightly, and can sometimes fail. It is usually a last ditch effort if all else fails.
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I was with you until the last two sentences. I don't believe those to be true, or maybe I should say they are overly pessimistic.
[Edited on 7-25-2012 by JZ]
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EnsenadaDr
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Well, let's put it this way. The Doctors (Cardiologists) that I worked with always tried medications first. If the case was especially severe, they
would refer the patient to an electrophysiologist (a Cardiologist that specializes in the electricalconduction of the heart). JZ, you are BURNING the
myocardium (heart muscle) in ablation which could cause irreversible damage. It is not something to be taken lightly.
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DavidE
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Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
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Ensenada Dr, I sure lucked out when I happened to draw an internal medicine specialist who had practiced in the Philippines for the first 20 years. I
kept complaining about crazy blood pressure spikes. He came up with an idea. He changed my medications to extended release type of the exact same
stuff I was taking for years. Bingo! Like magic it worked. His explanation: "Sometimes regular medicines of this type really vary over the course of a
dose period. it can start an oscillation in blood pressure". Also cured my elevated pulse episodes.
If I cut myself I bleed like a stuck hog. The docs in the states said I should be on coumadin with a history of afib, but if I never get afib now, and
my blood appears to be not overly enthusiastic about coagulating? ? ? ? Sodium Warfarin isn't something I would wish to be on with lab services so far
away. Anyway I have a good stash of amiodarone. Evil side-effects but effective if I ever need it. Aspirin! Well, we'll see.
A Lot To See And A Lot To Do
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EnsenadaDr
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David you have an excellent understanding of cardiac medication. I wanted to mention that your comment about Magnesium was right on. The first thing
a good Doctor will check on a patient with a cardiac arrhythmia is their electrolytes, specifically, magnesium, potassium, then sodium, chloride. We
used to have a protocol in the hospital for electrolyte replacement so the nurses didn't need an order. Amiodarone has some wicked side effects as
you mentioned, but is good in a pinch for an arrythmia.
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DavidE
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I went on a steep learning curve with meds and photo-sensitivity with me playing the part of guinea pig. I did not read the tiny warning sticker on
the bottle of amiodarone. Then I drove from the states 5 days into Mexico with my left arm on the window sill. Also when they had me on that medicine
I got those deposits in the cornea. Scared me to death to see chunks of black floating around in my vision. I have spent many, many hours researching
medical reference websites. I still have a funny perception of medicines -- the part about what is more likely to harm a patient, the malady or the
medication. Again, thank you for your participation on this forum. I more than read your responses, I study them. :-)
A Lot To See And A Lot To Do
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EnsenadaDr
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Thank you David
Thanks for the kind words, David. My responses come from many years of on the job experience and studying as well. | Quote: | Originally posted by DavidE
I went on a steep learning curve with meds and photo-sensitivity with me playing the part of guinea pig. I did not read the tiny warning sticker on
the bottle of amiodarone. Then I drove from the states 5 days into Mexico with my left arm on the window sill. Also when they had me on that medicine
I got those deposits in the cornea. Scared me to death to see chunks of black floating around in my vision. I have spent many, many hours researching
medical reference websites. I still have a funny perception of medicines -- the part about what is more likely to harm a patient, the malady or the
medication. Again, thank you for your participation on this forum. I more than read your responses, I study them. :-) |
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BajaBlanca
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very intersting thread as this is what we just went to the States for last week - a cardio-version
but I am getting ahead of myself:
4 years ago Les began having A-fib while we were traveling in Europe. He had a cardio-version there, then another, and was Ok for a while but soon
realized he was still not right.
trip home and straight to UCSD hospital where he had many tests done - we ended up choosing Dr. Feld, one of the creators of this procedure, who does
not take new patients any more. Les underwent 8 hours of ablation and then was great until 2 weeks ago when he felt bad again.
He had a choice of re-doing the ablation or trying the cardio-version again. He chose cardio-version and so far feels fine.
In his family, it is not genetic, as far as we know. In Europe they asked if he had had a bad cold, which he had not. Anyone else know of theories
as to the "why' some get this and others don't ?
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EnsenadaDr
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As a person gets older, the chances for acquiring AFib increase. Wear and tear on the heart, and damage to the myocardium (heart muscle) can cause an
interruption of the electrical activity of the heart. Heart attacks or blockage of the coronary arteries which can lead to interruption of the oxygen
supply to the heart and death of part of the heart muscle, can cause an electrical disturbance in the heart. A "cold" or virus can cause
cardiomyopathy, or a diseased and/or ineffective heart muscle which can signal an electrical disturbance. There are many causes. Age and
atherosclerosis, or hardening of the arteries, is probably the most common cause. A young, beautiful girl I worked with had episodes of SVT and
needed an ablation at age 30.
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DavidE
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Blanca, Why not try a magnesium supplement? It's cheap, healthy, and no medicine other than amiodarone could keep it from returning in my case. This
isn't "Linus Pauling and vitamin C" theory*. A shortage of magnesium seems to cause arrhythmia even in people, young people with no history of heart
problems.
*I joke that when I catch cold even though I take lots of vitamin C that at least the virus can't get scurvy.
A Lot To See And A Lot To Do
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Udo
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Glad you mentioned myocardium, which was the major contributor to my heart damage, including the death of part of my heart muscle.
Had it not been for my wife running marathons, I would be in a coffin by now...the story behind that is that I volunteered to pick up her marathon
goodies bag at registration, about 17 years ago, and I went into one of the free blood pressure check booths. The technician asked me if I was
planning on running the marathon the next day, because I would have collapsed by mile 5. He advised I immediately see a doctor, which I did the next
week.
I had absolutely no symptoms of anything. I was a picture of great health...rock climbing, kayaking, hiking, backpacking, four wheeling, etc.
I learned my lesson...see an MD at the slightest symptom of ANYTHING, particularly at my age.
| Quote: | Originally posted by EnsenadaDr
As a person gets older, the chances for acquiring AFib increase. Wear and tear on the heart, and damage to the myocardium (heart muscle) can cause an
interruption of the electrical activity of the heart. Heart attacks or blockage of the coronary arteries which can lead to interruption of the oxygen
supply to the heart and death of part of the heart muscle, can cause an electrical disturbance in the heart. A "cold" or virus can cause
cardiomyopathy, or a diseased and/or ineffective heart muscle which can signal an electrical disturbance. There are many causes. Age and
atherosclerosis, or hardening of the arteries, is probably the most common cause. A young, beautiful girl I worked with had episodes of SVT and
needed an ablation at age 30. |
Udo
Youth is wasted on the young!
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Udo
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I take lots of Vitamin C and lots of Omega-3 fish oil. Have not had a cold in over seven years now.
| Quote: | Originally posted by DavidE
*I joke that when I catch cold even though I take lots of vitamin C that at least the virus can't get scurvy. |
Udo
Youth is wasted on the young!
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EnsenadaDr
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Asesino Silencioso
Yes, Udo, High Blood Pressure, or Hypertension, is what I tell my patients in the clinic is the Asesino Silencioso, or the Silent Killer. It is
silent, often with no symptoms, but deadly. | Quote: | Originally posted by Udo
Glad you mentioned myocardium, which was the major contributor to my heart damage, including the death of part of my heart muscle.
Had it not been for my wife running marathons, I would be in a coffin by now...the story behind that is that I volunteered to pick up her marathon
goodies bag at registration, about 17 years ago, and I went into one of the free blood pressure check booths. The technician asked me if I was
planning on running the marathon the next day, because I would have collapsed by mile 5. He advised I immediately see a doctor, which I did the next
week.
I had absolutely no symptoms of anything. I was a picture of great health...rock climbing, kayaking, hiking, backpacking, four wheeling, etc.
I learned my lesson...see an MD at the slightest symptom of ANYTHING, particularly at my age.
| Quote: | Originally posted by EnsenadaDr
As a person gets older, the chances for acquiring AFib increase. Wear and tear on the heart, and damage to the myocardium (heart muscle) can cause an
interruption of the electrical activity of the heart. Heart attacks or blockage of the coronary arteries which can lead to interruption of the oxygen
supply to the heart and death of part of the heart muscle, can cause an electrical disturbance in the heart. A "cold" or virus can cause
cardiomyopathy, or a diseased and/or ineffective heart muscle which can signal an electrical disturbance. There are many causes. Age and
atherosclerosis, or hardening of the arteries, is probably the most common cause. A young, beautiful girl I worked with had episodes of SVT and
needed an ablation at age 30. |
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Barry A.
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| Quote: | Originally posted by Udo
I take lots of Vitamin C and lots of Omega-3 fish oil. Have not had a cold in over seven years now.
| Quote: | Originally posted by DavidE
*I joke that when I catch cold even though I take lots of vitamin C that at least the virus can't get scurvy. |
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Hmmmmmm, I do too, Udo, and I seem to catch at least 2 colds a year. We are all different. 
Barry
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David K
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Glad you are doing good now Udo!
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bajadock
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Marathons? KUUUL conversation coming up with Jana this weekend.
Great thread and lots of great info, ALL. Reminds me of BajaNomad a few short years ago!
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EnsenadaDr
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Very nice website Doc
I am also very impressed with the caring and concern you show for others Doc. We need more people like you in the community. | Quote: | Originally posted by bajadock
Marathons? KUUUL conversation coming up with Jana this weekend.
Great thread and lots of great info, ALL. Reminds me of BajaNomad a few short years ago! |
[Edited on 7-26-2012 by EnsenadaDr]
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EnsenadaDr
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I had a patient come into the Maneadero clinic, a 22 year old with his heart racing unbelievably. The first thing that someone needs to do, when they
feel their heartbeat going out of control, is to do what is called the Valsalva Maneuver. You sit on the toilet, and you bear down as if you are
going to have a bowel movement. This creates a negative pressure that affects the vagal nerve which will slow down your heartbeat. I told this boy
to go in the bathroom, and go for it. He looked skeptical, but I waited outside the door, and I asked him if he was trying it. I told him don't be
embarrassed, keep trying until the heart slows down. After about 2 minutes, he came out and said his heart was back to normal. I then referred him
to a cardiologist. Most cardiologists recommend this first and then a carotid massage. If that doesn't work they will try cardioversion. Some women
as they go through menopause will have some arrhythmias, and need a beta-blocker or a calcium channel blocker to control further episodes of this
happening.
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Udo
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Your input has been invaluable, EnsenadaDr.
Hope you can show up the this Saturday's wine event in Punta Banda...studies have shown that red wine is beneficial to the heart.
Udo
Youth is wasted on the young!
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EnsenadaDr
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Thank you, Udo
Would love to attend but I will be in San Diego this weekend!! Enjoy!! | Quote: | Originally posted by Udo
Your input has been invaluable, EnsenadaDr.
Hope you can show up the this Saturday's wine event in Punta Banda...studies have shown that red wine is beneficial to the heart.
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BajaBlanca
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I will certainly look into the magnesium supplements ... sure is an easy solution.
Never did I guess that I should have asked for medical input/info on this forum 4 years ago when Les had his first episode of rapid heartbeat. It was
one of the scariest times as neither of us had any knowledge at all about what was going on !
His heart muscle is fine but the arryhthmia (sp?) bothers him no end. We have been told that many people have A-fib and live their whole lives Ok
with it. For Les, it causes extreme tiredness, with the first bout (when we were in Europe), he would wake up gasping for air. It was so horrible
that he took regular 1 a.m. or 3 a.m. walks, came home and slept better.
thanks all.
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