Cardiac ablation: my journey

I had the most irrational thought whilst under sedation for my cardiac ablation:

This is quite relaxing really!

Given that catheters were, at that point, travelling through a vein at the top of my leg to reach my heart, I think it is safe to assume that the sedative was doing its job!

My journey to get to that hospital theatre was not easy. Up until an hour before the procedure I was ready to bolt and hadn’t signed the papers. You see, I had done what we all know we shouldn’t do and googled the risks. And although this is a relatively safe procedure with a good safety record and a very low percentage of risk, those risks are terrifying:

  • Cardiac perforation,
  • Heart attack
  • Groin bleeding/brusing/vascular damage
  • Heart block
  • Stroke
  • Death.

As I kissed my sleeping children in their beds the night before and cuddled them at the school gates that very morning, I held them longer than normal and fought back tears, because worse-case scenario, according to the risks, it could have been the last time.

No-one forced me to get this done; it was a voluntary procedure. I had to weigh up the potential risks versus the benefits. And up until last November when I found myself on the kitchen floor after fainting, with a damaged front tooth, it was a procedure I did not think I would ever opt for.  Indeed, in the days leading up to D-day, the sayings:

You’re damned if you do and you’re damned if you don’t and

Stuck between a rock and a hard place

had never held so much meaning.  On the one hand, I was facing a lifetime of ectopic heartbeats: occasionally causing dizziness, rarely causing fainting and possibly, but not certainly, over time may, or may not, cause such a burden on the heart that left ventricular dysfunction occurs. On the other hand, this procedure could cure me, or reduce the ectopic beats; provided it didn’t result in one of the risks.

It was a horrid choice. But as I sat in my hospital bed and noticed the patient going in before me was a terrified girl; barely 20 years old, and remembered the few days in November when I couldn’t walk from one side of the room to another without blackouts, I felt it was a gamble I should take. I left the Consultants with one caveat: I did not want to come out worse than I went in.  If it got risky: stop!

Papers signed, the fashion show commenced as I dressed in their finest hospital gown and paper underwear (really, I had thought the baggy paper flatterers were the reserve of the maternity ward 😉 ) and had a cannula inserted in my arm for the all-important administration of sedative and pain relief.

Sometimes you come across people who could not be more perfect for their job, and the guy who wheeled me and my bed into the theatre was the perfect example. Light-hearted, funny and warm, he did a marvellous job of trying to keep my mind off the fact that I was about to undergo a heart procedure.

Let the fun begin!

This was no quiet tête à tête; more of a busy, yet calm gathering: electrophysiologists, cardiac physiologists, nurses and a radiographer. Cold sticky pads were placed on my back so they could map the electrical activity, coming from my heart, onto screens and countless electrodes were placed on my front. Probably the most physically painful part of the procedure was injecting the anaesthetic and then inserting the small tube, which the fine wires (catheters) pass through, into a vein at the top of my leg. Reminiscent of child birth, I squeezed the life-force out of a nurse’s hand as the small tube was inserted into my vein.

I had read that some people need a shot of adrenaline to activate their extra electrical pathways. As I expected, I did not. My nerves were so shot, my palpitations felt endless and so they mapped their location pretty fast and that’s when I realised the catheter was in my heart and I hadn’t felt its journey! As the sedative took hold, my head felt like it was swimming with a slight dizziness, and that’s when I had the vague, and wholly irrational, thought that it really wasn’t so bad.

Closing my eyes, for the next hour and a half, I visualised my favourite pastime; cycling. I pictured my favourite routes and mapped them out in my head: lanes, corners, hills, buildings, farm animals, dogs… and I imagined myself sailing down those hills and passing green fields. Over and over again!  As if struggling up a huge hill, I suddenly felt my heart racing; for seconds or minutes I am not sure. That’s when I realized they had started the arrhythmia electrically, via the wires positioned in my heart, so they could ablate the area of heart muscle it comes from.  With my heart pounding in my chest, it was even easier to imagine racing on a bike, although conversely, also a sharp reminder of where I was and what I was having done!  The next two or three ablations were different in sensation: less racing heartbeat, more intense tightness or pressure on my heart and then it was all over.

Has it completely gone? We don’t know, it’s too early to tell. But hopefully it’s improved.   Sometimes, when I lay down and all is quiet, I don’t recognise my own heartbeat: it’s silent, slower, unfamiliar! Some people have to go for a second procedure, only time will tell. For now, I hope it has reduced the frequency and in so doing reduced the possible burden the extra beats can place on a heart.

The next morning we were (politely) kicked out of our beds at 0630 hours in readiness for the 20+ heart procedures and operations scheduled for that day! Taking breakfast with three others; three of us who had had ablations and one who had had a pacemaker fitted, weary smiles all round, we marvelled at the wonder of today’s medicine and the amazing people who had helped us. And as I tentatively walked to my transport it struck me as incredible that less than 24 hours after a heart procedure I was on my way home.

If you are reading this and also considering this procedure, consider how much your arrhythmia affects your daily life and ask your consultant which risks are relevant to you. As what my google search hadn’t made clear is that risks vary depending on which part of the heart is being ablated; there are different types of ablation procedures for different heart rhythm disturbances.  From my experience, of course there are far more pleasant ways to spend a day, but the procedure was quick and I am told the recovery is too.  I am not on my surgical-distracting-bike yet, but I am mobile; albeit a little tired! And hopefully in the coming weeks and months, I might just find out that my arrhythmia has been reduced too!

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Behind every smile

I feel my head bang against the stone floor; one time or repeatedly, I’m not sure.   In my dream-like state I am vaguely aware of my hands, and maybe my arms, shaking. And as a strange male voice creeps into my conscience – asking if I am okay – things gradually start clicking into place.  Disoriented I sit up and it slowly dawns upon me that I have just fainted and my front tooth possibly broke my fall, as it hurts like hell!

They say that behind every smile lies a story and this is mine; the most difficult and deferred post I have written.  For as long as I can remember I have had low blood pressure: feeling dizzy and having to lie down after a hot bath or sauna, eschewing the temptation of a bubbly hot tub and experiencing momentary blackness if I stand up suddenly. But it was okay, it was manageable.

Now that certainty has been thrown into disarray as I am no longer sure my low blood pressure has always caused my dizzy spells: in the past year and a half, I discovered I have ectopic heartbeats (an irregular heart rhythm).  News that was freshly and inconveniently delivered as my husband embarked on a four-month deployment overseas.  I threw myself into filling the lonely months ahead with an endlessly busy diary; anything to stop wandering thoughts about a dicky ticker!  I tried not to dwell [too much] on who would get the children ready for school, how I would get them to school, who would help with their homework and cook their dinners and who would look after me, if I experienced bad dizzy days whilst he was away.

Four months later my husband returned and I had thankfully only experienced one dizzy – yet perfectly manageable – day.  Interestingly, this was the day after he left, so in all likelihood it was caused by stress.  Many hospital appointments and tests later – 24 and 48-hour heartrate monitors, two echocardiograms, countless ECGs and one hour-long MRI  -and I am a patient at a specialist hospital and on the waiting list for catheter ablation.  Thankfully, it can be cured; through the wonders of modern technology I can have catheters inserted to zapp away the offending electrical impulse.  But should I; would you?

You see on the one hand I have been assured that my heart is perfectly healthy and that I can (unless having a dizzy day) carry on as normal.  I am very active: I spin, I cycle, I hoop and sometimes I even jump rope!  And in one a half years I have only had two bad episodes; both flu-related.  But on the other hand my recent faint was a bit of a turning point, my volte-face: when an operation suddenly didn’t seem so implausible.  After four days of worsening-dizziness, I reached a stage where I couldn’t walk more than a few paces.  It was debilitating and terrifying.

Hopefully the faint was a one-off, I suspect caused by the flu jab, as the only other time I have had bad dizzy spells was a year before, in the days leading up to the flu.  But a nagging doubt wonders if the dizzy episodes are worsening. I know that I don’t want my first thought every morning to be wondering whether it is a dizzy day or not.  I don’t want to worry about re-discovering the unforgiving stone floor every time I come up from bending down to retrieve my children’s dirty laundry, or unloading the dishwasher.  But, like most, the procedure is not without risks.  And so behind my smile is a furrowed brow as I weigh up the pros and cons of an-almost impossible decision.

I would love to hear from you.  Maybe you have had catheter ablation and felt it was the best thing you ever did.  Or maybe you decided to not risk tinkering with your heart and plough on without?