Docs said based on stress test June 2018 that my heart is in great shape. I think my issue is being caused by too much focus on speed which then started a behavior feedback loop. Getting excited about speed caused a-fib. A-fib made me anxious. Anxiety caused more a-fib.
I'm starting a new program to re-train my heart to beat regularly and break me of my speed behavior. I'll focus on running slow and steady. In the stress test I got up to 155 BPM and had no event so it's not the effort that is causing the issue.
10/29/2018 Update: Looking back at the opening of this blog I see the wishful thinking. After research and doctor appointments I know that afib happens and there is no real cause. There is no cure, only treatment.
I'll try to track my runs in this diary.
2018
- June
- - June 5. Very good. Ran 2 miles at lunch at work started with fast walk for 4 minutes (too long I think). Kept my HR around 125. 70º and sunny, nice breeze. Normal food. No a-fib. https://mysports.tomtom.com/app/activity/259232392/
- - June 9. Ran with Mary B at Antietam in the morning. A very nice and easy run with no issues.
- June 12. Ran 30 minutes at lunch. Very slow 13 min pace but kept HR mostly at 130 with a few exceptions. When I noticed it creeping up I was able to control it easily. It's so hard not to push when you know you can go much harder. But, I'll pay this price for the time being to see how it goes. 70º and light humidity. Very nice out. Was a couple times when I thought it might try to jump but I could have imagine it. Hills are the worst. I've trained myself to dig into them. 30 minutes later HR almost back to normal resting 52 BPM. https://mysports.tomtom.com/service/webapi/v2/activity/perm_2autF7kzZRDxHbqn3x5QyXLrxVtRudqeNxHFaggxRFs_PlcLWJCRPHVblHH2AEwa3ZNzCvymPjG7Zh_X7ze3Kg?format=html
- AFIB June 12 - So after the run which was great I went home and the weather was nice so I washed the trailer. Good hydration, no apparent reason but I had an event. It seemed lighter than others but did last into the night. Didn't sleep well and the event was still happening when I got up for work. Probably stopped around 10 AM. Only thing I can attribute it to was excitement of hurrying to get the trailer done. This seems like a common theme.
- June 16 - Played music the night before. Got up early for a run with Mary B. Ran 2.5 miles with no event. It's very nice to be running with her again.
- AFIB June 18 - After work CTG had a bike ride on the Western MD Rail Trail. Nice easy ride. 12 miles. HR never got to 120. Stayed hydrated. At the end of the ride there was a bear on the trail. Me and Jonathan approached to scare it off the trail so the kids could pass. I guess it was the adrenaline of the moment but after the bear was gone I had an event. No too strong, about the same as the previous one but it lasted all night and into the next day which seems to be the usual. No sleep and feeling pretty crappy the next day. I'm thinking I see a pattern of adrenaline or excitement.
- June 20 - ran at work and felt great. My watch battery died so I had to go by feel. I kept a steady breathing pattern of 4 in, 2 out throughout the run. I think it was about 2.5 miles. I never felt that an event was close to happening. After an hour my HR is at 60. Seems normal. Mid 80s and mid humidity. Clouds so the sun wasn't too blazing hot. Hoping all the magnesium is helping.
- June - July Vacation - Ran every day on the beach without incident. Kept HR below 140. Towards the end of the vacation I let it creep to 142 without incident. There were pretty hot mornings when I ran.
- AFIB July 10 - Ran at work. 93º and medium humidity but it felt good outside and I felt strong. After 10 minutes afib started so I walked back. HR was in the right zone and I never felt like I was pushing. However looking at my tracker I started out at 9.45 pace and steady slowed to 11 throught throughout the run. Hoping the magnesium will lessen the severity and I'll get a better handle on how to prevent these. A thought about the running on the beach, I was always running on empty. I wonder if that has anything to do with it. This is a bummer though. 2.5 hours later the afib stopped and I'm back to normal. My next test will be to continue once the afib starts. I want to know if it was less sever because of walking immediately or if it's the magnesium. I might try increasing the magnesium.
- AFIB July 12 - Another afib day. Ran at work. 87º medium humidity. Very pleasant out. I tried to learn from the prior run and keep the pace down. I started at about an 11 pace and slowed to around 12.. HR never got above 135. 7-9 minutes in I started feeling some flippy feels so I slowed a little. I went into afib around 10 minutes into the run, just like yesterday. I ran the same route which did include uphill for the first mile. I'm sure that has something to do with it. As an experiment I decided to continue running at a slow pace. HR returned for a short period to 135 but then bounced around again. I want to see if the afib stops after 2 1/2 hours like it did yesterday. All a grand experiment but simply this sucks. I shouldn't have to do this with as healthy as I feel. Cardio appointment on Monday hopefully to discuss options.
- AFIB July 14 - Not a good week. Ran twice, 2 events. Today I was cleaning Linda's gutters. It was hot and I was going up and down the ladder but I felt great. I was actually excited to think I could do normal stuff. After cleaning I was carrying the ladder back to the shed and the afib hit. I stopped and took a drink break hoping it would be minor. It lasted through the night and into the morning. Melatonin may have helped sleep a little, I'll try a second dose in the future though because from about 3.30 until 5 I couldn't sleep. Prior to that I tossed and turned all night. Sunday I was wiped out. I see the doctor on Monday to discuss next steps.
- AFIB July 21 - After resting for a full week I felt good and went for an Antietam run with Mary B. Slow, 16 minute pace, beautiful weather, HR never above 125. At the end of the run there is a steep hill. I ran this before with her without afib. This time I had it and it lasted all day and into the night. 12+ hours. Got an appointment with Dr. Shorovsky with UMD Medical Center in Westminister for August 1.
- July 28 - No events through the week. Saturday while using the push mower afib started around 11.30. I was being careful to not push myself. Weather was warm and a little humid but really nothing extraordinary. Symptoms were mild but steady. Went to church Sat night, had dinner, watched a movie. Didn't sleep well. Sunday morning at 7 I was still in afib. This was one of the longest that I remember. It stopped around 8.30. No issues through the rest of the day. Concerned that this is getting easier to trigger and lasting longer, eventually leading to persistent afib. Cardiologist appointment on Wednesday. REALLY hoping he has good answers.
- August 1 - Saw Dr. Shorovsky in Westminister. He was factual and explained all of the percentages of success and failure for ablation. Afib is a disease that is not curable. It is controllable. Meds don't work for long. Afib should not affect your life. So if you have afib and it doesn't cause you a problem there's no reason to treat it. In my case it causes an issue; I've changed my lifestyle dramatically to accommodate afib. I don't want this. I want to be able to run and be as active or more active than before. In this case ablation is a good option especially for me; young, healthy, and active. He described that they perform the standard pulmonary vein isolation to start. If additional work is needed they look to other areas. He feels that starting in other areas does more harm than good. I discussed complications and asked how many his team has had in their experience. He said there have been no deaths and that the complications follow the percentages from the various studies. He is one of four doctors that perform the procedure. The procedure is an outpatient procedure done in Baltimore. You spend the night and are admitted if needed. Most are not necessary. First 3 days after you should not exert so that you don't affect the entrance site. After that you can perform whatever activities you want including running. If the procedure is going to not work they want to know as early as possible. I think I will take a conservative approach and will walk for the first month before I add some jogging. Prior to the procedure I will need cardio mapping and MRI to determine vein placement. I will be on blood thinners through the recovery time and a small time prior. During recovery there could be cardiac events while the heart heals. These happen 30% of the time and usually resolve after the healing period. He believes they will be able to schedule me in September.
- AFIB August 3 - After work feeling great, helped Mary B do the shopping for the parish picnic. Afterwards we sat to watch a movie. No stress, no activity, boom: afib. Started around 9 pm and lasted through the night. It wasn't as strong as other events but lasted a full 12 hours. Not much sleep because of it.
- AFIB August 10 - Friday night hanging out with MB. Felt odd all day. Was probably anxiety over worrying if I was going to have an event. Went to be late feeling a little flippy. Elevated HR but not afib. Woke up in the night in afib. Like the previous week it was not very strong. I don't know if I'm concerned with the strength. Am I getting used to it, is it becoming normal? Or is it just not strong because I haven't been running. I really miss running and can't wait to do it again. Saturday morning still in afib went for a 3 mile walk with MB. Feels better to be moving than sitting. Leaves me feeling pretty wiped out after an event.
- AFIB August 18 - Afib for no reason about mid-day. Same old story. At least it seems to be getting milder. I'll be happy when it's gone.
- AFIB August 25 - Afib for no reason. Seems like the weekly thing. Not too strong though, I guess that's a blessing.
- September 1 - All week I felt a little flippy. Saturday I had afib for a few minutes but then it stoped. Monday (holiday) same thing, a little flippy through the day but then it never started. I wonder if I'm just getting used to it or could it be changing. I plan on getting on the treadmill to see if I can do some running without it starting. I ran hard on my stress test without it starting. If it doesn't work I guess no running at all. I don't want to lose strength though.
- October 22 - I haven't been recording anything because it's been fairly stable. I found that I can't run at all or it gets triggered, even on the treadmill. It changed a bit where it wouldn't last as long and wouldn't be as violent but was happening more regularly. This had me worried that it changed to the point where the ablation will not be useful. I have no way of knowing other than to say that living while trying to not set it off is a bummer. My weight is a little up but I'll be able to correct that. I've been doing push ups to at least feel like I'm doing something good for myself. We went camping this past weekend and I had a full-blown afib attack on Saturday. I think it started in the night and lasted until around 4 in the afternoon. It was rough. Probably one of the top 5 events I've had. I'm actually glad I had it. I reminded me of how this thing sucks! Thursday I get the ablation and I hope to be posting positive news after that time.
- October 29 - I had the ablation on the 25th as scheduled. The UMMS heart center folks are awesome. I didn't have a single bad thing to say about them. They were all knowledgeable and friendly.... and I hope to never see them again. Mary B stayed with me through the whole process; she's a trooper and it was hard for me to see her so scared. Dr. Applebaum talked with me the next day and explained that all 4 veins were active. They are supposed to be active in normal folks. They used cryo ablation to isolate the veins and then tested some more. They found some areas that were tricky so they were zapped with RF ablation. The recovery from anesthesia was a little rough, about the same as a bad drunk really. They gave me a single stitch in my right groin which was removed the following day. Catheter removal sucked a lot. I was discharged at 2.00 on Friday and had a relaxing day at home. It felt great to have a shower the next morning. No complications from the procedure. I feel a skipped beat or small flutter every now and then. I went for a 1 mile walk on Sunday the 28th and felt great. I expected to. I took the full weekend to relax even though I missed being with the family; they had a hair day on Sunday.
- October 29 continued - first day back to work. In general I feel fine. It may be wishful thinking but I feel like my heart is more relaxed, less excited. I have the occasional missed beat from time to time but nothing like I felt prior to the procedure. It's very possible that prior to the procedure I was simply in a high-anxiety state and was feeling those affects. I did my usual morning walk and felt fine. I took the stairs in the morning but used the elevator for the rest of the day. I want to rest as much as possible this whole week. Next week I'll go back to push-ups and using the stairs multiple times a day. I set up my 1 month followup with Dr Dean for Nov 26. That's my target date to start running again. I will take it easy; I'm sure my body will make me. I've really had a lot of time off from running and getting back into it may be hard. Writing this around 3.00. Was pretty tired by the middle of the day. I'm sure that will improve. Not sleeping well. I think it's because of the elevated heart rate during healing. My usual resting rate is 50. My resting rate is now 75 ish. Sitting at the computer doing nothing and I'm around 80. It's high but I don't really feel it. I just feel like my body is working even though I'm not moving. Hard to explain, sort of altered states. Here's to getting better and better.
- November 2. Last day of the work week and I'm feeling very good. The effects of the whole ordeal started to wear off on Wednesday. I've had to be careful to not overdo it. Still taking the elevator. At home it's been hard to go to bed early because I'm feeling good but by the end of the day I am pretty wiped out. Sleeping has gotten a little better but I'm still sleeping lightly. Spent some "time" with Mary B yesterday and my heart felt very good. I'm excited at the idea that I may be able to run afib free after the healing is done. I have a nasty bruise on my arm that seems to be from someone sticking my wrist multiple times during the procedure. My wrist and forearm are sore and it wakes me up at night. It was a little better last night which is hopeful.
- November 13. There were a couple of days last week, toward the end of the week where my heart was doing weird things. It felt a little like afib in that I felt very confined and agitated. I could feel a missed beat in my carotid and during that missed beat I felt a very defined thud in my chest. I never felt like my BP was bad but I didn't check it. I seriously don't want to become neurotic about my numbers. By the end of the three day weekend I felt very normal again. Saturday was cold and I was outside during a lot of the day cleaning the workshop and putting away winter stuff. I felt normal again. I think that's the best way to put it. I feel like my old self. I am getting tired by the end of busy days but I feel like that's to be expected with being only 2 weeks from the procedure.I went hunting on Monday as a test of the ticker. The first hill to get to the park is 100 feet of elevation. Before the procedure my heart was thumping pretty hard up this hill. I took it slow and steady but I didn't get winded and my heart felt great. It was encouraging because it felt a lot like running. My heart was working but not overly stressed. My breathing was like running. I was encouraged enough that I spent 4 hours and covered a lot of the park including a final hike up about 350-400 feet of elevation. Again I took it very slow and steady but felt good. I hiked other hills as well. I also spent some great quality time with Mary B after hunting and then covered the trailer. I was pretty wiped out by the end of the day. I slept through the night for the first time since the procedure. That was wonderful. I started my push ups in the morning again, 25. I stopped at 30 when I left off but I didn't want to push it. No weird heart rate. Feeling good and encouraged. Praying a lot for a full recovery and successful ablation.
- November 20. The past week has been crap. After Monday's wonderful hunting, Tuesday I went to work with a weird ache in my stomach. After a couple of days of feeling pretty bad I called Dr. Shorofsky to ask if I should be concerned with EAF (Esophageal Atrial Fistula). He said the symptoms were trouble swallowing, fever and chills, blood in vomit or stools. None of those symptoms apply. by Friday I realized that I was stuffy and dizzy feeling. I took a decongestant that I had at work and felt much better. I rested on Saturday but did stuff around the house. I had my first gig since the ablation at the Woods. It went well but I think I had afib through the second set. Very anxious, very weird heart beat. I could blame it on a lot of things. They keep it a million degrees in there. I may have been dehydrated. I got no sleep on Saturday night, got up early for church. After church I got some decongestant meds. They helped. I had a lunch gig at Hoffman's. I felt good after that but tired. Monday at work I felt a little better. Today a little better still. My stomach is really bugging me but I recall feeling like this when I was on nexuim. I'll stay on the PPI through the course even though I think it is causing the stomach issues. I think the sinus is aggravating the stomach issue as well. I hope to run for the first time this weekend after Thanksgiving. I'm looking forward to that since that's always helpful with anxiety which I'm having a lot of because of the concerns over EAF. Without the ablation all of these symptoms would simply be a little sudzy feeling. Looking forward to getting back to normal again. Praying a lot. None of this is good for Mary B. She's been amazing though, as always.
- November 26. This was a great weekend in many ways. I went hunting on Friday afternoon and got a fox squirrel. Prepared it on Saturday morning. Very good eating. I stopped my PPI meds and my stomach is feeling much better. I ran sound for the church dance and danced with Mary B a lot and felt good the whole time. Sunday morning I went for my first run since the ablation. It felt very good. I was tired and walked a little but that was more because I didn't want to push through anything. I went t total of 3 miles at a 13.49 overall pace. I felt great after. I felt very normal. I went to the winery with Mary B in the afternoon and had some white wine. I had a lunchmeat sandwich in the late afternoon. I felt a little flippy into the evening. I don't like it but I can live with it for now. I don't like how anxious it makes me feel. I slept pretty well but woke up a half hour before the alarm feeling odd. Maybe sinus, not sure. Through the morning there have been moments of flippy but not bad. I see the cardiologist for the first follow up this afternoon.
- November 27. cardiologist was happy with my EKG. Said it sounds like I'm moving along the expected path. BP was 120 over 70 which is good. Resting HR was 65 which I think is weird because when I count it it's 72-76 but whatever. He says that my HR will go down once I get back into exercise. I agree but found it odd that he acted like an increased HR was not expected after ablation. I ran on the treadmill today at lunch. 20 mins at a 12 pace on the random setting. HR was steady around 140-144. It felt great and I'm very hopeful that it all continues. I felt like I remembered feeling before all this started. Very excited and thankful..
- December 27 - I haven't written for a long time because I'm feeling great. I've been running a bunch and although slow, it feels great to be back into it again. I feel like my old self after runs. As soon as I stop I can feel everything slowing down like it's supposed to. I guess in the time preceding the afib I was feeling different but like a frog in a pot of water I didn't know it. I feel different overall now and it feels good. I still have the occasional odd beat but I may have that forever, who knows. I won't go back to pushing myself on runs until the spring. For now I'm happy to be able to finish 3 miles at an 11.30 pace with an average heart rate of 150. Mostly it's my legs that are tired. I may try a longer slower run as I get closer to the 3 month milestone, we'll see. So thankful to be feeling better again.
- January 10 2019 - Happy New Year! I've been running three times a week for a total of around 7 miles per week. For one thing it's hard to get miles in with the colder weather but it's probably a good thing since I'm trying to take it easy and ease back into running. There have been a few weird heart days. For instance a week ago I ran 4.25 miles at a nice slow pace. I watched my HR and kept it at or below 140 the whole time. Since I hadn't gone that far in a long time I was pretty tired but felt great. No heart issues. However, later that evening at church and later I felt like I was having many skipped beats. This most likely caused major anxiety which exacerbated things. I felt fine by the next morning and haven't had anything since. I'm still plugging away with the running and my times are improving but I'm not pushing it. I'll be happy when I get to the point where I'm no longer worrying that my heart will do something weird and I can simply run freely again. That may take a long time like it did with my stomach issues but I believe it will happen. I'm 2 weeks away from my 3 month blanking period. I feel that it has been a success. I'm feeling very good overall. I'l also be happy to get a few more miles and speed under my belt and lose this 10 lbs that I gained while not running and over the holidays.... It will happen.
- May 21 2019 - Just keeping up to date. I've been steady running and feeling great. No issues. I do still have an occasional dropped beat. I notice it more in the evening. It doesn't seem related to anything in particular. I'm still getting 7-9 miles a week and my pace is pretty much back to where it was originally. I feel a little more tired in general but I really think that's due to stress and maybe age. The stress is from still not really being back to normal in the head. You always have that little feeling that something might happen. This is a brain feature that got our race to where we are now so I won't knock it. I just need to build up enough positive running memories that the balance shifts. I'm stating to explore how fast I can run a mile. I ran a nine minute mile last week... I even walked a little in it and still hit 9. Feeling very good.
