The ablation

I suppose at some point I should get around to jotting down here some specifics of the ablation procedure I had done last Tuesday, March 5. It's not that I don't want to talk about it, but, yeah, I kinda/sorta would just as soon not think about it. Still, there's the posterity aspect, and someday I may need to recall this stuff (like when I need to have this done again). Plus, I know you've been dying to hear all about it!!

WHAT I HAD DONE

I don't fully understand much of this, but I think it was called a Catheter Radiofrequency Ablation. They went through my groin with tubes and wires and burned parts of my heart. Or, as the clinical notes say:

Procedure Name
1. Ultrasound-guided bilateral femoral vein access
2. Ultrasound-guided right femoral artery access for blood pressure monitoring
3. Electrophysiology study
4. Intracardiac echocardiogram
5. Transseptal access x 1–Baylis versa cross
6. Three-dimensional electroanatomical mapping–Abbott
7. Pulmonary vein isolation–cardio focus X3 laser balloon
8. Radiofrequency ablation–cavotricuspid isthmus ablation for typical atrial flutter
9. Manual pressure and figure-of-eight sutures for hemostasis

As near as I can tell there were 23 actual ablations - whatever that means.

WHY I HAD IT DONE

I was hospitalized and diagnosed with Atrial Fibrillation (AFib) on November, 14, 2023. They did a cardioversion (shocked my heart back into rhythm) on 11/15. I then wore a monitor for two weeks and it was determined that I had persistent AFib. They suggested since it was fairly early and I'm in otherwise good health, I was a good candidate for ablation.

At the time of the procedure the EP (electrophysiologist) said I also had Atrial Flutter, which he could fix with the ablation as well. I don't know the difference.

THE PROCESS

The procedure was scheduled for Tuesday, March 5, 2024 at the Lutheran Heart Pavilion. After fasting since midnight the night before, I arrived at 5:30am with Jane holding my hand. I had preregistered and already paid the ~$3,800, so it wasn't long before they took us both back and strapped a bracelet to my arm. Then it was off to get me ready. My nurse was also named Jane, and she was super. I put on my gown, got an IV, a tech came in and shaved my front-side from neck to knees, and then I chatted with the anesthesiologist, his assistant, the EP (Dr. Rodriguez), and probably a couple other people. Right around the scheduled procedure time of 7:30am a nurse came and wheeled me down to where they did it.

The procedure room had a ton of people in it. They were all joking around and very friendly. They had me walk from my bed over to the operating table. First I sat up and they stuck monitor pads (or something) all over my back and front. People were asking me questions and everyone seemed to be talking at the same time. Finally they told me to lay down with my head on this little pink piece of foam. The anesthesiologist had told me in my room that he could give me something to help me relax before the actual anesthesia if I wanted. I told him to feel free to give me anything and everything they had! The last thing I remember is someone saying, "Okay, you can give him the good stuff," and someone else said, "He's already getting it." :)

The next thing I know I was waking up and a nurse was leaning over the side of my bed. She said they were all done and she asked me some questions (I think). Then I vaguely remember being pushed down the hall back to my room where Jane was waiting.

According to the notes I arrived in the operating room at 7:30am; the physician arrived at 8:14am; and I was out of the room at 9:59am. So almost exactly 2 1/2 hours (which is what they said it would be).

RECOVERY

I'm guessing I was in post-procedure recovery for about 1/2 hour coming out of the anesthesia, because I thought I got back to the room with Jane around 10:30. I remember feeling very relaxed and sleepy.

It was kind of a blur for awhile, but I remember them asking what I wanted to eat. There were several options and I chose yogurt with blueberries and granola. I remember Carrie being there because she said something like that's what I would be having at home. They also let me have coffee through a straw - which tastes different for some reason. Anyway, I remember it all tasted pretty good.

I needed to lay still for 3 hours to make sure I didn't bleed from the insertion sites. About that: for some reason I thought there would be one incision in the artery (or vein) in the groin area. What they actually did was go into BOTH SIDES of my groin, but instead of an incision they sort of just punctured the skin with a tube. So I had no stitches in my skin, but they did use sutures to close the artery/vein. So, I had to lay fairly still for 3 hours until they removed those sutures and made sure I wasn't bleeding. 

I don't really remember much about that 3-hour waiting period. That and the incision are what I had been most concerned about, and neither was much of an issue. 

At 1:30pm the nurse removed the sutures - and I didn't feel a thing! Then I had to wait another 30 minutes and as long as I could walk and everything seemed okay I was free to leave.

At 2pm the nurse accompanied me down the hall, I stopped and peed at the restroom, then we went back to my room and they removed the IV and told me I could get dressed.

By 2:30pm they were wheeling me out to the door and Jane picked me up to take me home!

RECUPERATING AT HOME

For 48 hours I was supposed to take it easy and avoid: heavy lifting (5 pounds or more), continuous stair climbing, prolonged walking, and squatting or bending for prolonged periods of time. The EP also suggested I take at least 5 days off from running, but I could otherwise resume normal life.

The rest of that first day I actually felt pretty good. I spent most of my time in the recliner and we watched TV.

I didn't sleep great the first few nights. My chest hurt and it was a little hard to breathe Wednesday and Thursday. I don't know if it was swelling from the ablation or the anesthesia (or both), but they said to expect it. It wasn't terrible, but I've never had a hard time breathing other than the couple times I've had bruised ribs. It's not fun.

Thursday evening was my first venture out of the house. We went to a play the two grandsons were in. It was a bit of a chore, but actually felt good to get out. Leaving their school I felt better than I did arriving. That night was the first good sleep I'd gotten and I felt much better Friday.

I think Saturday was my first actual "walk" outside and that went well. I hadn't really had any pain in the groin area like they said I might.

Saturday night I tended bar for a concert and... that just about did me in. Being on my feet for 5 hours of activity was probably not a good way to ease back into things, but I survived. I had a little groin pain, and was pretty wiped out. Fortunately our church doesn't start until 11am Sunday, and that arrived early enough. After resting the rest of Sunday, though, I felt like I was almost back to normal.

Monday afternoon I did an easy 4-mile jog and it went better than expected. My legs were a little tight, but nothing other than from being a lazy slug all week.

Wednesday was an 8-mile run and it went pretty good. Again I kept at an easy pace, which was 10:15/mile and included stopping at several lights because I went from our house to downtown. I guess I did walk a tenth of a mile during the 6th or 7th mile, but the run felt fine. I was kinda wiped out after though.

This morning was 5 miles, and I did it on the treadmill at 6am because it was supposed to rain all day and I just didn't feel like that right now. Actually, it's been storming. 

So far I feel like I'm back on track not only as far as general health, but maybe even the marathon at the end of April. My only concern is if my achilles tendons can deal with the week off or not, but I'm trying to be cautiously optimistic.

As for whether it "worked." I don't know. And probably won't until my scheduled return visit to the doctor in June. Apparently it takes 2-3 months for the heart to fully heal and during this time I can still have AFib and flutter episodes, but that doesn't necessarily mean the procedure wasn't successful. In fact, I had an AFib episode the morning after the procedure! My resting heart rate has been running higher than it used to, and I can feel things get a little wonky from time to time. However, everything else seems to have healed up, and I feel pretty good. I don't seem to have tired spells for as long or as often, and that's maybe the biggest problem I had before. So, we'll see.

And... there you have the long and short of it, folks (if anyone is still reading). Perhaps the only thing to deal with now is the itch of chest hair growing back!