I had not planned to do a next part in this series so soon since had not had any issues and the plan from my Cardiologist was to just keep an eye on things. As with most things plans change when the situation changes and one has to just go with it. You don’t gain anything by dwelling on the “might have beens” or the “what abouts” so just need to deal with “what is.”
So, what did change: well since my issues on a 100 mile ride then a rowing workout about 13 weeks ago where I had an accelerated HR a number of times with the rowing workout being the highest at 206 I had not had any issues to speak of. I had my CTA scan done (see part 6 ) on August 10th that set out what was the current plan of doing what I usually do and keep an eye on things. Due to this I was planning a long outdoor ride September 12th with my last long outdoor ride the first weekend in October and was working my miles up some to get ready. Then came this past weekend and my first recorded AFIB event.
I had gone down to Gatlinburg on Thursday, a week ago, as was meeting up with someone on Friday and just figured take a walk around Gatlinburg and have dinner. This will play in soon but I was a little tired and going up three flights of stairs to a restaurant I felt a little out of breath. So that is what we did then when got back to the hotel I did my usual check of my heart with my Kardia 6L and for the first time got a reading of AFIB. As usual when I get what seems an abnormal reading, for me, I took another one and it too said AFIB. I just relaxed and right before bed took another reading and again AFIB as did my retake of it. I really did not feel any flutter or heart racing but was tired and thinking back the stairs earlier makes more sense. Unfortunately, I did not bring my Frontier HRM so could not use it to get a continuous reading. The next morning I again had an AFIB reading and again did a few other scans before we left the hotel and they all showed AFIB. During the day I did not feel much as far as heart rate but going up stairs was more tiring than it should have been. When I got home in the late afternoon I checked again and still showed AFIB and did so till around 9:30PM. I was able to get some readings on my Frontier as put it on when I got home and it showed the same till about 10:30PM when I got my first regular reading and the end of the AFIB. Since then have not had another AFIB reading.
I sent all the data I had from the scans to my Cardiologist but as it was a weekend and I did not feel it was an emergency had to wait till at least Monday to hear back. When they did get to me on early Tuesday the answer – sort of what I was expecting – was to start on Eliquis, more on this in a moment, and to be scheduled to use a 3 day halter to record what is going on, well for at least those three days. As far the Eliquis, which is a blood thinner/anti-coagulant, it is to help stop the chance of a stroke/heart attack. The issue with AFIB is that due to the irregular heart beat the chamber does not empty and then the blood can pool and if it creates a clot – what drugs like Eliquis are intended to stop – and that clot then later gets ejected it can then create a stroke. The issue however is that drugs like Eliquis create a greater risk of excessive bleeding in the case of a fall or other event that causes bleeding internal or external. I am not excited about taking them right now but will for a bit but do not see that being on it for along time is realistic, let alone its cost as it is expensive. There is one other issue, I am sure there are more, but if you need say a dental procedure or medical procedure with Eliquis you have to stop Eliquis 24-72 hours before depending on the bleeding risk for procedure then can’t start up again for 1-3 days. So, you can’t just go in for a procedure. One thing I did find, as it is relatively new for Eliquis, is there is an antidote for reversing bleeding caused by Eliquis called Andexxa. I did listen to a presentation on a new drug that is such that it deals with the kind of clot you get in the heart but does not stop, well at least allows some, clotting in the case of injury. It is called Factor XI and is in Stage 3 trials so is 1-3 years away from regular use. The other option out there but not a lot of trials on it is to use is a natural blood viscosity regulator like Nattokinase, which I already was taking, at a therapeutic level (10,800FU), don’t use now as would not be good. But for now that is hard to get a doctor to prescribe as less data on it. For me I have heard that if you get an ablation and it clears up your AFIB you can go off the thinners but we shall see.
With all this going on and being on the anti-coagulant I have canceled out on a plan to ride a 77 miler in early September and a 109 miler in early October as riding is just not safe. While I do not fall very often – actually the last time I fell was in a parking lot talking to someone and my cleat not disengaging – any fall can be dangerous especially if you get unseen internal injuries as the clotting effect that should happen does not. Actually, when I got the Eliquis I was told that if I hit my head they have to do a scan and then do one every few days after to make sure there is no bleeding. Sorta, bummed and was on a site where I saw the question come up on riding outside while on thinners/anti-coagulants and some said they would not give up riding. I do not think that seems wise since while I enjoy riding outside with others and alone it is not worth my life and since I can still run and row I have outlets for my competitive side. Let alone I can still ride and race on Zwift – so for now will stick to that while I work through the rest.
As I write this I am into the last of the 3 days with my Zio Monitor and while I have felt a off a few times my Kardia did not show anything but we shall see. I did do a 30 minute row to get in something with an elevated HR and did a Zwift ride with a hard effort. Once done I send the monitor back and they send the results to the doctor and then we move on from there. Sort of a Catch 22 as while I really do not want an AFIB episode having one while on the monitor gives useful information. One of the treatments for AFIB is an ablation – the one I think that seems the best is a Pulse Phase Ablation – but I guessing they need to be able to know where to ablate and thus need AFIB to take place somehow.
That is where I am now and hope I will get info back from the cardiologist after Labor Day - maybe sooner – but we shall see. As I have said before I know that in this God is working on me, especially in the area of patience. One key to patience is a well-grounded trust in God in the midst of the good times and “what we may see” as bad. Earlier, in Part 2, I mentioned Romans 8:28 which says God uses “ALL” things for our good as believers and his Glory. That verse really helps me to truly see God as my strength and refuge in times of turmoil where things do not go as I planned – but as God desires and will use as we see in Psalm 46:1.
“God is our refuge and strength, A very present help in trouble.”
Being a Christian is not meant to be simply a moniker one claims but is to be integral to life and that means relying on His Word to guide and give hope. While I know I may fail to do as I need to do I also know the road God has me on is not promised to be smooth but is to be one He is with me on. I always think about John Bunyan’s Pilgrims Progress where he talks about how Pilgrim more than once is faced with what looks like an easier path but when taken leads away from the desired destination. Thus it is with life, we are often sold that life should be smooth and easy but that is a trap. This does not mean if things are going well we are to worry but that we are to be content no matter as long as our focus is on moving forward to be all God desires us to be and in the process glorify Him.
More to come as God works in and through me!
By the way I hope all this is helpful not only if you are in a similar situation but also to help you see that no matter our situation in God there is hope no matter the situation.
Past Posts in Series
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