thursday

the 15 packets of sugar they delivered with my oatmeal and two cups of coffee for breakfast Thursday morning

The afib stopped about 9 Wednesday night, they came in twice during the night to take my vitals and I was glad to see my blood pressure and pulse with good numbers but when I woke at 6 Thursday morning almost immediately an afib episode started so since I had been admonished by the day nurse to buzz them when I feel it happening, I buzzed the night nurse. Because my vitals had been good during the night I was surprised when she said I'd been in and out of afib all night. And flutter I asked. Yes flutter too she said. So it didn't work? I'm not a doctor she says.

After she went out I cried a little but I thought what good would that do me besides make the afib episode worse and raise my blood pressure and stuff up my nose and make my eyes red. It certainly wasn't going to improve the situation so I stifled it as best I could and blew my nose and wiped my eyes and tried to pull up my big girl panties but my mood had darkened, was in no mood for visitors. The episode didn't quit after the normal length of time and even got worse. I hadn't had one this bad since before I had started on the metoprolol. Well, I guess I'm not going home today after all I thought, so WTF, I'm worse off than I was before I submitted to this whole process...flutter not gone, afib worse, a bruised throat, and a hole in my groin. Yay! So I started a list of questions for when the doctor showed up and reminded myself that even so I was in much better shape than all the other patients on the floor. Decided FB and Twitter weren't doing me any good so no more of that and then I tried meditating to get it down which did help but didn't bring it under 100 and later even jumped to over 140 but went down again. This one didn't stop til right before 2 PM. At 4 the doctor was still a no show so the nurse went to give him a call. About 5 his physician assistant showed up and they came in to do another EKG. You've been in afib the PA says. Yes, it started just after 6 this morning and stopped a few minutes before 2. That's right, she said, you can tell, she asked? Yes, I can always tell.

Anyway, the EKG showed a perfect sinus rhythm but I wouldn't let her leave until I had asked all my questions which I won't go into detail here but, yes, the ablation worked. The flutter on the previous EKG was not generated in the right atria but is a different flutter associated with the afib in the left atria (remember, I had two different conditions) so the ablation in the right atria was a success. If it's going to revert, she said, it does so immediately and after the doctor zapped the spot he tried to induce the flutter again and nothing happened. So. It is possible that in a year or two the spot might heal or find a way around and it could revert and another ablation would be necessary but that only happens in about 5% of cases she said. The doctor wanted to observe me for another few doses, if nothing else happens he will release me. If I continue to have afib episodes he will try a different medication. If none of the meds stop it but only partially control it ie keep my pulse rate below 100, is that life threatening, I asked. No, she said. So ablation of the left atria is a quality of life choice. Apparently they are more concerned with keeping the heart rate below 100 than with completely stopping the irregular rhythm.

All stayed well and when the night nurse came around at 9 PM to give me the eliquis she told me she couldn't give me my next dose of the sotalol because my heart rate was in the high 50s and they had instructions not to give it to me if it dropped below 60. So how is the doctor supposed to observe me on this medication if he won't allow it to given to me?

Friday morning my pulse was still under 60 so I probably wasn't getting my morning dose either though I'm pretty sure under 60 is my normal resting heart rate and all I had been doing for three days was resting. Well, I had had enough of that and so I ordered my breakfast, put on my housecoat and slides and started walking the floor while I waited for it to arrive which caused a bit of a stir. The nurse hurried over making sure I wasn't woozy (every patient on the floor is considered a fall risk regardless and in fact the aide had told me earlier I was the only one on the floor that could walk, every one else being too sick I guess). After awhile she came in with my morning dose, it worked, she said, your pulse is up.

About noon the doctor came in. Ready to go home, he asked. Yes! Marc arrived promptly to come get me but it took until 3 PM to get all the necessary paperwork in order so it was nearly 5 before we got home.

I went ahead and went to the pharmacy before I settled in at home. Oh, the pharmacist says, we have to order the sotalol, we don't have any but they checked the sister pharmacy in El Campo about 12 miles down the road and they did have it so they transferred the prescription to them and I went to pick it up. Life in a small town.

So far so good. I haven't had a major afib episode since the one ended 2 PM on Thursday but since Saturday night every 3 to a dozen beats or so it will skip a beat or add one off and on, as if the afib is trying to manifest itself, and my pulse has remained consistently low from about 48 – 64 bpm. I imagine it will take some time to adjust to the medication now that I'm taking it twice a day and perhaps it will need to be adjusted. Right now I'm just taking it one day at a time. Haven't felt like getting out and doing any sustained yard work but I'm still supposed to be taking it easy for a few more days and it's too damn hot out there anyway.

previous:

the test and the procedure

recovery and observation