Sunday, 21 April 2019

Living with Paroxysmal Atrial Fibrillation

Today's an anniversary of sorts.

In April 2013 I woke up in the early hours of a Saturday morning with my heart beating wildly and very fast, thumping hard in my chest and clearly out of rhythm.  Given the history of heart disease in the family, I thought my time was up ...

I called the ambulance service on 999 but they weren't as concerned as I was (!) when I said I had no chest pain, and they told me to make my own way to the nearest hospital with an A&E department.

Once there, I was seen quite quickly, given aspirin & beta-blockers, lain on a bed and hooked up to an ECG machine.  Soon afterwards, the symptoms subsided somewhat and I left the hospital late on the same morning with some further medication and an appointment at the hospital's regular Chest Pain Clinic on the next Monday, although I hadn't actually experienced any pain at all.

Another ECG at this next appointment, and then booked in for an ultrasound scan of my heart, the results of which were that my heart seemed structurally sound but I had suffered an attack of atrial fibrillation (AF or A-Fib in the medical jargon), where the chambers of the heart beat out of synch with each other.  They said it could either be the start of a longer-term problem or it might never happen again.

Anyway, after a shaky couple of weeks or so when I was afraid to do anything at all, I got back into the usual life routine and, apart from a few minor episodes where my heart seemed to flutter and miss a few beats, all was generally well.  I wasn't taking any regular medication after those initial hospital appointments.

I'd read up a little on the AF diagnosis, and that left me looking for triggers which could have set-off the problem.  The night before, we'd had a pizza at home with friends and a lot to drink, and alcohol seemed to be one of the key triggers that affects a lot of AF sufferers.

But for a long period I carried on as normal apart from the odd minor flutter, until another major episode occurred in October 2014 when I again ended up in hospital, and again it had followed an evening of too much wine.

This time, I had more ECGs and another heart scan, and was then prescribed medication to be taken daily in an attempt to control the attacks.  I take the same medication to this day, and will be taking it for the rest of my life.   

In the next year, in August 2015, I had another major episode early one evening in the garden while enjoying a few bottles of beer after a round of golf, and I took myself off to A&E again.  This one was more worrying in that I was taking my medication regularly and was only on my second bottle of beer at the time, so I wasn't drunk like I'd been on the previous occasions.

Afterwards, I was generally OK except for several instances after I had been drinking - I'd sometimes lie awake all night with my heart pounding although not actually jumping out of rhythm.  Oddly enough, it was never suggested by the medics that I stop drinking alcohol altogether - my GP, who's also an AF sufferer, says he always takes an extra tablet beforehand if he knows he'll be having a drink later !

But no more major AF attacks again until one night in Tenerife in early 2017, when I again found myself in hospital after a night of drinking too much wine.

And that was the last time I touched an alcoholic drink, more than two years ago now.   There are a few other triggers that seem to affect me to a lesser degree, such as chocolate, but luckily I don't suffer any reaction to one of the most common triggers of all, which is drinking coffee.  

Stress can also trigger AF attacks, but I have a more relaxed lifestyle these days and don't tend to get too stressed-out on a regular basis.  Lying in bed on my left side can also make me more aware of any arrhythmia.  

Over the years I've worn portable 24-hour 'ambulatory' ECG devices a few times, which record the heart rhythms over an extended period and during 'normal' daily activities, but I've never had even a minor episode when wearing such a device.

The last time I felt my heart racing hard and wildly out of rhythm for more than a few seconds was on Christmas Day 2017, long after I'd given up the alcohol, but it only lasted for a few minutes and I didn't go to the hospital that time.

So in the absence of alcohol, the frequency and severity of the arrhythmia attacks seem to have reduced although I'm certainly not symptom-free.   Last year, 2018, was quite a good year with no major and fewer minor episodes, but I've began to suffer a little more again during the early months of this year.

I can be breezing along as normal and suddenly feel a fluttering in my chest and a sinking feeling in my stomach.   During these minor episodes I can feel a slight irregular heartbeat for up to several hours, although I'll take an extra dose of medication as soon as they start.  They can leave me feeling tired and out of sorts for days afterwards, until my confidence to continue with everyday tasks returns.  

The medication itself can sometimes also make me feel lethargic and much more easily tired.

But, on the plus side, my arrhythmia seems to be very mild compared to some other AF sufferers, who can have severe attacks that last for several days at a time and require more serious intervention than daily medication to control it.   So there are far worse problems I could be suffering from, and six years after that first attack at least I'm still here ...

I'm also lucky to be employed by my own company, where I can generally set my own workload and schedules, because if I was working for anyone else I'd probably have taken a lot of time off over the past few years, to the point where they'd might have wanted to find an excuse to sack me.

So for those out there aspiring to financial independence, I'd say try to get to the minimum subsistence level as soon as possible because you never know what could hit you one day out of a clear blue sky.  The last thing you want is a potential long-term health problem and money worries at the same time.

And do I miss the drinking ?  Well, yes, but it's simply not worth the anguish any more.   There's nothing like a few beers to quench the thirst on a hot summer's day, especially after a game of golf, but at least there's quite a decent range of non-alcoholic beers and wines available nowadays.

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