Thursday, July 16, 2015

Camping, Next weeks plan (Cardiology Procedure, Anesthesia), etc.

Article related to the arrhythmia my EP (Heart Rhythm) dr. and Cardiologist suspect and are looking to try and get rid of in the EP Study next wk:
http://atrialtachycardia.net/ectopic-atrial-tachycardia/
Editing this to add an 'ectopic' beat which is what my Cardiology Team feels the abnormal heart rhythm/heart beat likely is, is defined as:
ectopic
/ec·top·ic/ (ek-top´ik)
1. pertaining to ectopia.
2. located away from normal position.
3. arising from an abnormal site or tissue.

This past weekend was a blast, I am really not at all a camping type person, for a few reasons but had such a good time with my Sister, niece and nephew and my Parents who where already up at the Campground in Shawano a few days before Sara and I got there.
The campground includes a small store, outdoor eating restaurant that also has different types of ice cream, the beach which you can check out paddle boats, canoes and swim (water was pretty warm though I just walked in while the kids swam).
There is many different games to check out from ladder ball, horseshoes (I think that's what it is called), basketball, tennis (lol at my Sister and I and my Dad who joined us after a while, he was busy having fun taking pics initially). ;)
We took out one of the paddleboats (another site to be seen I'm sure as the water was so wavy from boats and wave runners). There is woods that was right by our site for Zan to catch butterflies in, walking paths and so many more activities for kids (and grown up kids?!?) =)
Best of all perhaps it didn't rain this year!
I have been feeling short of breathe on and off throughout almost every day, worst when I got upstairs in my Apt bldng to do wash, walk out in the heat or even often from room to room. Is just very variable. in a way it seems worse then before the AVR surgeries but I am sure the humidity and high temps don't help. My Cardiology Team advised on "high humidity days to avoid being outdoors" due to the lung and heart issues but for real, I love warm weather and being outside and if I have to walk a little slower or stop a little more to catch my breath i'd do that vs letting life pass me by over symptoms!
Thankfully although symptoms due occur fairly frequently I do also get many periods w/less or no symptoms of being short of breathe (SOB).
The fact I feel short of breathe quite often simply leaning down to say fill the cat dishes and walking 5 steps back over to set them down is a little disconcerting some days but that to, hopefully the EP Study next week will help this if my Team is able to find an arrhythmia and it is amenable to being ablated (using electrical activity through separate catheters to burn the inappropriate signal(s). If my Team doesn't find an arrhythmia then we'll likely move on to the new heart failure (HF) med and hopefully that will help slow heart rate and in turn help symptoms... Ironically this cardiac test takes place exactly 1 day short of being 2 yrs since the 1st OHS (AVR/Konno Procedure) took place in 2013. Odd how that happened! This study mapping the heart and potential ablation should be a wee bit easier (without a doubt!) than the Aortic Valve replacement, aortic root enlargement and VSD Patch where + subsequent 3days of being sedated/intubated 2 yrs ago!
I think the worst part will likely be laying flat for so long (3-6hrs for procedure + 4-6 hrs after where i'll have to keep my legs straight though I am reallllyyyy hoping my Team will let me lay with my upper body somewhat upright. I plan to talk to my Team about this, the worst they'll say is no, right?
My EP dr feels w/the EP Study if either A. they don't find an arrhythmia (abnormal heart beat) as suspected or B, they find an arrhythmia but upon trying to ablate/get rid of it the site isn't able to be ablated then he, myself and my Cardiologist will sit down and discuss the Ivabradine. The specific arrhythmia the EP dr. suspects is an Ectopic Atrial tachycardia or extra/early beats occurring from the atria I believe is what that means.
If we opt to go the new med route he feels it takes about a week to slow heart rate and they generally give 1-2 mo to see if it will help symptoms or not. After that 1-2month period we'd re-eval and either con't on it and keep monitoring or B. go fwd with the Mitral valve replacement. I had asked if once someone has Valve replacement are they able to come off the HF med and he said he could not say in my case for certain. His thought was at whatever point we opted to do the Mitral valve replacement they'd keep the med in place till after and then do a trial I believe he said going off of it to see how I did without it. It seems he and Dr.Earing (Cardiologist) feel there may be issues separate from the mitral valve affecting the heart failure and they just don't know and wont know if all symptoms would go away/if meds would be able to be stopped post any MVR until after.
I guess I see no or little point in worrying about that all till we get to that point, was just info I kind of was curious about.
The actual EP Study and ablation if they find an arrhythmia they feel may be ablatable is Weds, 22nd at Children's and as planned now will be my EP dr and one of his Partners (also an Heart Rhythm dr.) + the Anesthesiologist who did all my previous heart surgeries and procedure. Although it would have been nice had the procedure occurred a few wks ago as originally planned as we likely would be moved on to the 2nd step (if needed be and maybe even be working out the shunt valve change details).. BUT I also feel really comfortable with the approach we are taking w this procedure and anesthesia approach and more comfortable having the Anesthesia dr. there who is so familiar w my history and did all former OHS surgeries and procedures.
With this procedure/Heart Cath we are using mild conscious sedation so i'll be numbed up where the multiple catheters are inserted and given very mild sedation but also be awake and apparently aware to give the best chance of success finding the suspected 'EAT' arrhythmia (which as Dr.Kovach explained is a type of abnormal rhythm that typically "goes to sleep when pts. go to sleep" and so they have to do the catheter procedure awake. I am ok with this, a bit nervous about the headaches BUT I also know the Anesthesia dr. knows my history and if need be (i'll talk to her ahead of time) perhaps Dr.Taylor can give something to help if I got nausea from laying flat. Admittedly the other thing that makes me a tad nervous (but where better to be I guess if it is the case) is feeling short of breathe during the procedure. Will take it as it comes though and not to worried or nervous.
Talked to Dr.Bragg's Nurse:
On a separate note I talked to Dr.Bragg's Nurse earlier this wk about possibly seeing her (Dr.Bragg) to see if she might be willing to tap the shunt and take off fluid to give relief which Lisa thought would be ok. Given Dr,Bragg was/is out of the office this wk, it seemed to make sense to wait and see her till the wk after the EP Study that way I should have an idea from my Cardiology Team what their plans are post this procedure and should be able to get their ok in the mean time that Dr.Bragg could start scheduling the date to put in a different shunt valve. This way I can talk to her about all of it at that appt to?..
In any case that's about it, will update after the study next wk if nothing else,
Thanks for stopping by,
Erica

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