Sunday, October 02, 2011

My Ablation Adventures...

Whew...what a crazy few months it's been.  Updating this blog has had to take a backseat to family stuff, and some health stuff.  Hopefully things are settling down now so I can write more regularly.  I've had so many people ask about my health I thought I should just explain it all here...

Two and a half years ago, I started having trouble running.  One day I would run 9 miles with no problems, and the next I would have to stop several times to catch my breath.  The first time it happened I thought I just must have been having a bad day...maybe I didn't eat right, was dehydrated, was getting old, or just in a funk.  But when it started to happen on a regular basis I knew something wasn't right.  We had a trip planned to Colorado and I started getting a little nervous about going to high altitude if there was something health-wise going on, so I decided to get checked out.  My doc sent me to a cardiologist, who ordered a stress treadmill/echo cardiogram.  I passed with flying colors, except for some little thing the doctor wanted to take a closer look at.  (He told J it might be a Myxoma, a common tumor inside the cavities of the heart, no big deal).  Luckily, it was nothing, and he said I was fine to go skiing.

But in the following weeks my "exercise intolerance" continued, so we were referred to a pulmonologist who said I had "exercise-induced asthma".  I began a $300.00/month regimen of inhaled corticosteroids as well as albuteral as needed, and was hopeful I'd get it under control.  J didn't believe I actually had asthma, because after running 9 marathons and doing several triathlons over the years, I had never had so much as a cough or wheezing episode.  And I wasn't wheezing then, either.  It was hard to really describe the sensation, but I felt my chest tightening, so I couldn't get a good breath.  It felt sometimes like my heart was beating outside my chest.  The only thing I could say for certainty was that a few minutes into a run, I HAD to STOP!  I mean, had to stop.  I couldn't go on.  But I never had to gasp for breath.  My doctor told me that asthma doesn't always present itself the way you see it on TV, and he was certain that if I continued the medication it would help. 

Fast forward about two years to the beginning of this past summer, and it was worse than ever.  It happened every single time I exercised, no matter what kind of exercise I did.  Swimming, biking, running, stairmaster, elliptical, hiking, etc., all gave me the same symptoms.  As addicted to exercise as I am, I continued to exercise through it.  In pain, but way slower and less intense than usual.  I would just go twice as long.  J finally got frustrated with the whole situation when we were on a bike ride.  It was our loop around the neighborhood in North Carolina, very hilly and a great workout.  Typically I would loop him on the long uphills, but that day I couldn't go five minutes without having to stop to catch my breath.  I was in tears.  So he called his cousin, who is the head of NYU hospital in New York.  He put us in touch with Dr. Frances Adams, one of the top asthma specialists in New York.  We decided to fly up for a quick visit with him.

I loved him.  He was very kind and understanding, even when I cried and blubbered through the whole consultation explaining how much I missed running.  He said we would figure it out and felt sure we could find a treatment that worked.  Heck, there was a list a mile long of olympic athletes with exercise-induced asthma, so if they could do it, surely I could.  So he ordered another battery of tests, which weren't conclusive, so he sent me for another treadmill test, even though I told him I had passed one a couple of years before.

I had to go back to New York to drop H off at the airport for her trip to China this summer, so we scheduled it for that time.  J wasn't with me.  I was hooked up to an echo, and started walking on the treadmill, which increased the incline and speed every 3 minutes.  I could see the EKG while I was walking, and it looked like a normal heartbeat to me.  I have lasted over 20 minutes in the past during this test, but about eleven minutes in, my EKG started going crazy!  It looked like someone took the needle and started scribbling up and down.  As soon as I got the words out, "Hey, what is THAT?", he stopped the test and had me lay down really quickly. 

Long story short, I had a bout of Ventricular Tachycardia, where my heart rate went from 110 to 200 and started beating very erratically, originating in the ventricular area, not the atrium, where it normally does.  The doctor explained to me that that is likely what caused my exercise intolerance.

"Wait, WHAT?  I don't have asthma?" were the first words out of my mouth.  The next, "Can we fix it?"  The answers were yes and yes.  I probably didn't have asthma, and there was a fix, a cardiac ablation, where they go into your heart with tiny catheters, induce the arrythmia so they can map it, and then cauterize the electrical pathway that causes the irregular beats.

I was referred to a cardiologist in Nashville, at Vanderbilt, who ordered a zillion more tests to rule out the presence of heart disease: MRI, calcium screening, cat scan, and a short cardiac catheterization to check out my pulmonary artery.  Then he told me, "Well, I'm the plumber, and you need an electrician."  So I was referred to an EP, who had me take a week of verapamil, then re-do my stress test.  The medication did not do anything, and my v-tach and PVCs showed up easily during the test.

The cardiac ablation is nothing short of miraculous, at least to me.  I had to spend one night in the hospital, but they didn't have to completely put me to sleep, went in through my groin so they didn't have to cut me open, went into my heart and found the short circuit and fixed it!  I was groggy during the procedure so I don't remember much of it, but I do remember feeling a couple of the burns when they cauterized.  I was kind of moaning and I heard them say, "She's feeling that," and I don't remember anything afterwards so they must have given me more sedative.  I woke up and they were ecstatic that they were easily able to induce the V tach, and fix it, and when they tried to induce it again they couldn't!  I'm sure a lot of it was the medication, but I cried like a baby when they told me that.

I had it done on Monday, came home from the hospital on Tuesday, walked a little bit Wednesday-Friday, and yesterday I test-drove my newly ablated heart by going on a 3 mile run.  With NO issures at all!!  I felt like I could have run longer, but I wasn't supposed to so I walked the rest of the six mile loop.  It's now six days post-op and I am so optimistic that they really did fix it.  I didn't realize that the almost constant palpitations I was experiencing, even at rest,  weren't normal, but now that I don't have them it's an amazing feeling.   I will have to wear a monitor before my follow up with the surgeon in a couple of weeks, so they will know for sure, but I'm keeping my fingers crossed.

I've spent too much time on the internet, reading about other people's experiences with ablation, which is not a great idea.  There are lots of failed ablations out there, but I think the people who have good results probably aren't on the forums looking for answers.  It's a very common procedure, and I am going to stay positive that I'll be back running marathons in 2012!