7/25/08: Hernia, A-phib and overzealous doctors

Was in the hospital the past 2 days with Atrial Defibrulation (a-fib). This was a small complication from the hernia operation I had 2 weeks ago, which was an indirect result of the MS. I thinned out my blood, spent the night in the hospital, and my heart converted. Here's the story.

One of the problems with MS is dehydration and the associated constipation that can come with it. Neurogenic bladders and bowels can join forces to make sure you always have a struggle with the bathroom......here's how. You drink the recommended amount of fluids in a day (half the body weight in ounces....for me 120oz) and you keep the bowels moving. Trouble is you have to pee all the time, at the most inopportune times. Don't drink enough water and the pee is better controlled but the constipation picks up. Hard to win.

During the course of diagnosis of my MS, one of the test I had at Mayo Clinic was to eject a balloon catheter from my backside after a series of sensation tests. I had a sever deficiency in the ability to detect waste in my colon, which is why I had so many accidents. The signal just wasn't getting to my brain that I had poop in the chute (sorry.......it is what it is) and I'd go a few days without realizing it. Suddenly the body would go through the ejection process to prevent harm.

Well, in the course of trying to eject the catheter and occasionally straining on the days I didn't drink enough, I developed a hernia. I had it operated on last October 2007, but it came back and I had it surgically repaired a second time a couple weeks ago.

My heart normally beats around 60 or less at night (thanks to all the exercise), and during the surgery it was probably just as low. I figure I somehow managed to get a small pooling of blood in one of the atria, because the 3 or 4 days following surgery I couldn't seem to get my heart beating right. I was feeling my pulse all the time and it just wasn't beating regularly. Instead of a rythmic bass drum, it was like someone playing the piano out of time.

It subsided a little some after a few days and I swam last week taking it easy, but each time I got out of the pool, it just didn't feel right. The past few days I began to feel it worse, and also in my breathing, so I finally went into the ER on Wednesday night to see what was going on. Atrial Defibrulation. Kind of like a boat propellor cavitating in the water. My heart was fine, but it just wasn't getting a good pump of the blood. And it was only moving the blood around my body about 75% efficency.

I was admitted, loaded up on blood thinners and my heart converted to sinus (doctor talk for got normal) during the night. I spent yesterday doing stress tests and ultrasounds to make sure I didn't have any clots or other problems, and I was released all ok about 3:00 Thursday. I was in the pool again this morning and it was nice having a 100% heart instead of one pumping about 75%. Could just feel it was right.

A-fib is pretty common. 2 million people in the country have had it, and some can't shake it. 3 people in the ER had it the same time I was there. It is usually caused by some type of disruption in the pump side of the heart or a disruption on the electrical side. If left in that state, it can lead to a clot which can lead to a stroke or a heart attack.

And that's where the overzealous doctor comes in. During the ER portion of the ordeal, I was visited by a number of nurses and doctors. The nurses and ER doctors all said A-fib is common and usually no big deal especially for a person my age with no history or family history of heart problems. They told me it should convert aywhere from 5 minutes to a few hours with the thinning of the blood, which ultimately it did.

The problems and stress level really started up when the cardiologist came to visit. He wanted to get right to business with a tube into my heart to check for clogs,then shock my heart back into rythym, followed by a cardiac ablation. Yeah right. Straight to a surgery to fuse up some of the tissue in my heart that is causing the short circuit. No regard to my history, level of activity, normal heart rate, lack of family history, nothing. Straight to the knife.

Needless to say, Kathy and I thought about the information we got from all ths people who visited. We decided if I was in the hospital under constant monitoring, the best thing to do was wait it out and see if it converts and do the non-invasive tests to make sure there were no clots. I can't even imagine how my quality of life would have been affected had I gone through an entirely invasive and unnecessary procedure.

The lesson here is to listen to the body and think. Get second opinions, talk to people. I don't believe any doctor intentionally wants to hurt someone, but I think they can sometimes get caught up in the moment and go too deep into their knowledge base instead of staying on the surface and dealing with what is before them. I'm a 42 year old guy with MS that is steadily improving. I have never had a single episode with my heart in the past, and have no family history of heart disease. The ONLY variable in the past 2 weeks when this all started was the surgery, which, even though it was a small surgery, does shock the body a little and can cause a few unwanted side effects.

I have learned to read the faces of the people who are examining you, especially the technicians who actually conduct the tests. They tell you they are not allowed to share results, but they aren't poker players. You can see them concentrating, studying, worrying, or talking to you like it's just a walk in the park. In this case the nurses were calm and cool, the ER doctors were easy going, and all the technicians on my stress and ultrasound tests were chatty. The only one who was worked up was the cardiologist. Maybe he was the one who was right since he was the one who has all the education, but in the grand scheme of it, I had time on my side and that was not a time to start cutting a perfectly healthy body open.

Obviously I am thankful for the medical community to take care of things like getting my heart beating right and being able to diagnose my MS. I'm also thankful to know that if for some reason my heart is out of whack and this happens again, there are some things I can do about it. But I also think it is so important to stay involved and ask questions. Sometimes something is really nothing.

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