Thank goodness our approach to cardiac arrhythmias has improved since 1990! I can’t imagine how it would feel at that heart rate for any period of time. Thanks for sharing the story, as unpleasant as the experience was.
I ended up with a bad GI bug last Feb to the point of finishing a case in surgery , dropping the patient in PACU and running to the bathroom to puke and voila, fast rate AF appeared. I knew it right away as I felt my pulse and was irregular. Drove to nearest hospital, maybe not the smartest idea in retrospect and went to ER. On the monitor, my HR was 140s-150s . I felt like I was on a treadmill at max speed. Didn’t break til 20 hours later after anti arrhythmic infusion finally broke it.
Yes, you're right... nowadays they'll just as likely zap you right away... Which is terrifying in its own right because they knock you out and you'll either wake up or not. Then there's the heart attack drug... This one briefly stops your heart in the hopes of a reset... That was the worst thing ever. It feels like a sledgehammer hits your chest and you can't breathe. Was given that twice in a row one time. 😂
I was used in that case to show the new residents what happens. The ER doc in that case took liberties because he happened to be my uncle. It didn't even work so it was just a terrible experience.
Yeah, I’ve been through the whole thing with paroxysmal Afib many times, with that sensation of feeling your heart nearly stop before it converts back to a normal rhythm. Feels like you’re going to die! I remember the ER doc sitting next to me watching the monitor and his eyes getting pretty wide as my heart rate was about 20 bpm and I’m still talking. After going the medication route many times and waiting for many hours to convert, meds eventually just stopped working. Ablation was done and has helped, but it wasn’t curative. Still get Afib, with rate a bit slower 😩. Doc wants me to do ablation again to touch up anything he couldn’t catch the first time. I think I’ll pass for now.
Too bad that prayer didn’t work! Another great story but a bad place to slip. We take our medical system for granted, but we do really have a good one!
I tried flecainide the first time I had Afib after ablation but it didn’t work at all. That was the recommended drug. Went back to verapamil and Propafenone, which works eventually. Episodes are much fewer, and heart rate isn’t as high, so I guess that’s something.
Oh, the prayer totally worked. Lol. I converted in that horror of a hospital thankfully. One time i was alone deep in the woods at a friend's camper. I went into AFib no medicine no way to go anywhere. But his Buddhist altar had blessing pills from this very great Lama who i briefly mentioned in a note previously. I broke into my buddy's stuff and took one of these blessing pills out. I put it on my tongue and in that very moment i converted. Another time i was in the hospital at 23.5 hours of amio... They were going to zap me. I received a call just before they were going to wheel me out of the room. It was my own teacher, a great Tibetan master...i told him they were gonna take me to shock me... He said that i was not to let them because this time it wouldn't go well. He then had me do a prayer/visualization practice (in Tibetan Buddhism visualization is a very integral part)... As i was listening to his voice over the phone taking me through this practice.. just moments before i was to get shocked, at the very last moment .. i converted. His blessings worked. Everything may be coincidences... But i don't think so. 😉
Maybe blessing pills is all we really need, or I need to be a Buddhist. I did have your experience of converting once within minutes of being taken down to be shocked and wasting an entire day in the ER. I still have avoided being shocked so far in my 20-some years now of paroxysmal Afib. I usually get it on weekends, when I'm least stressed--go figure--and least likely to find a cardiologist.
Those pills were unbelievably rare and the lama who made them is dead. Other Lamas would come from all over the world just to get these pills from him. They took about 12 days around the clock to make them with a full retinue of monks and yogis in attendance doing continuous prayers etc. I got to see another Lama make them at his monastery in Bhutan. I left with a bag full of them but it wasn't from that lama. His were special. Nectar accomplishment medicine is the direct translation of the Tibetan words. Dutsi mendrup. I actually do have some but it's sealed in a copper reliquary along with other relics and holy things. Lol. I had to wash that great lama's rugs in a holy spring but before i did i scoured them looking for his long white beard hairs. Hahaha. We are kooks. I found a few and added them to another reliquary. Had you met this being i promise it would make sense. How to explain the presence of an enlightened being? But it's unsubtle and almost anyone feels it around them. Chinese soldiers wanted to arrest this one famous teacher in Tibet after the invasion. Every time they got within 30 feet of him they would just sit down on the ground and bask in his presence. They never did arrest him. I taught English to a lama who was this master's student in Tibet... He told me first hand amazing stories about him. He watched his teacher leave a footprint on/in a boulder... Like his foot into the stone until there was an outline in the stone of his foot. They practiced together on top of a mountain and a rain of flowers fell from the sky. I said, wow... And the lama said, not wow... Even a black magician can do such things, what was most amazing about my teacher was his compassion.
It's been my experience that paroxysmal afib is still mysterious to many cardiologists. So, I don't take it for granted that we necessarily receive correct advice. I've left the hospital AMA a few times over the 34 years until I found a cardiologist who would listen to me. For awhile only procaine would convert me but they stopped using it except for the crash carts. I would insist they take it off the carts and give it to me. Then they stopped listening and insisted on amiodarone for 23 hours and if that didn't convert me they wanted to shock me (which i hate...i don't like being knocked out with no certainty I'll wake up). My point being... Sometimes they're wrong. Often they're wrong. I'd be curious what dose of flecainide and how often you were taking? Or just to convert? Because at the wrong dose it doesn't do anything. 100mg twice a day is the dose that worked for me. Conversion could be 100-300mg. But usually 100 would work.
Flecainide works really well. Either to convert after going into afib (usually within 3 hours) or if you take daily you possibly won't get paroxysmal afib anymore. Maybe my next story will be about falling down a marble staircase in Nepal outside of a Tibetan Buddhist temple landing on my back breaking and dislocating my shoulder and the compression on my back caused me to go into AFib. You don't want to go to a hospital in Kathmandu for AFib. It was like the basement hospital scenes from Jacob's Ladder. Pure horror. So I had a broken shoulder and I was in AFib. No ambulance, some roads washed out from a storm which is why I slipped on a marble staircase it was raining. Good Times. LOL. That was before I knew about flecainide so I just had to pray that I would convert because they couldn't help me. I managed to call the US and my uncle the ER doc I mentioned in the comment below and this compassionate man said to me, that's what you get for living in a third world country. Wow. I wanted him to talk to the doctors there to tell them what to do for me. I just hung up dejected and fearing for my life again. Even for the broken shoulder all they did was give me literally a shoulder sling unopened in a box. Didn't even take it out didn't even put my arm in it. And before they would agree to treat me at all they said I had to consent to paying triple the local cost due to being an American. 😂 Then they held me for ransom when i didn't have a thousand dollars in cash to pay for the zero treatment they gave. Finally a friend gave her laptop to them to hold as collateral. Misty water colored memories! Hahaha.
It was WPW...i was lucky to be able to be an experimental patient for the first trials of radio catheter ablations. I went on a 6 month waiting list and then had to fly to Oklahoma City where the doctor who invented the procedure was performing them at U of OK medical center. But since it was experimental they hadn't perfected it quite yet and even though they got rid of the bypass tract they left me with potential for afib. (And second degree burns from the multiple electrocardioversions throughout the 6 hour procedure. I was non responsive at one point so they just keep increasing the electricity... Topping out at 1200 joules for the zap that finally worked. But that much electricity burned me obviously. Better than being dead. Lol.)
I’m glad you got it correctly diagnosed and treated. I’ve taken care of a couple patients over 20 years with known WPW. Krikes! 1200 J? We defib at no more than 200 J on biphasic and upto 360 on older monophasic defibrillators, a fact you’re probably all too familiar with. My 1st location after school back in ‘03 was the cath lab at a very large academic hospital. Once a week, we’d rotate from cardiac cath rooms to the EP room where they did ablations for VF. Long cases ( upto 8 hours) and thankfully, we did them under general anesthesia so the patient wasn’t semi conscious for the duration.
Because catheter ablation was still experimental in '91 they weren't allowed to use anesthesia. So they had to give me an oral amnesic. I read the notes afterward and apparently I woke up during the procedure multiple times. But because of the amnesic I thankfully do not remember it. So it's probably just in my subconscious somewhere unknowingly screwing me up somehow 😂. The last thing I remember was when the nurse was shaving my groin to prep for the procedure and I suggested she should have at least bought me dinner first. Hahaha.
Thank goodness our approach to cardiac arrhythmias has improved since 1990! I can’t imagine how it would feel at that heart rate for any period of time. Thanks for sharing the story, as unpleasant as the experience was.
I ended up with a bad GI bug last Feb to the point of finishing a case in surgery , dropping the patient in PACU and running to the bathroom to puke and voila, fast rate AF appeared. I knew it right away as I felt my pulse and was irregular. Drove to nearest hospital, maybe not the smartest idea in retrospect and went to ER. On the monitor, my HR was 140s-150s . I felt like I was on a treadmill at max speed. Didn’t break til 20 hours later after anti arrhythmic infusion finally broke it.
Yes, you're right... nowadays they'll just as likely zap you right away... Which is terrifying in its own right because they knock you out and you'll either wake up or not. Then there's the heart attack drug... This one briefly stops your heart in the hopes of a reset... That was the worst thing ever. It feels like a sledgehammer hits your chest and you can't breathe. Was given that twice in a row one time. 😂
I was used in that case to show the new residents what happens. The ER doc in that case took liberties because he happened to be my uncle. It didn't even work so it was just a terrible experience.
Yeah, I’ve been through the whole thing with paroxysmal Afib many times, with that sensation of feeling your heart nearly stop before it converts back to a normal rhythm. Feels like you’re going to die! I remember the ER doc sitting next to me watching the monitor and his eyes getting pretty wide as my heart rate was about 20 bpm and I’m still talking. After going the medication route many times and waiting for many hours to convert, meds eventually just stopped working. Ablation was done and has helped, but it wasn’t curative. Still get Afib, with rate a bit slower 😩. Doc wants me to do ablation again to touch up anything he couldn’t catch the first time. I think I’ll pass for now.
Too bad that prayer didn’t work! Another great story but a bad place to slip. We take our medical system for granted, but we do really have a good one!
I tried flecainide the first time I had Afib after ablation but it didn’t work at all. That was the recommended drug. Went back to verapamil and Propafenone, which works eventually. Episodes are much fewer, and heart rate isn’t as high, so I guess that’s something.
Oh, the prayer totally worked. Lol. I converted in that horror of a hospital thankfully. One time i was alone deep in the woods at a friend's camper. I went into AFib no medicine no way to go anywhere. But his Buddhist altar had blessing pills from this very great Lama who i briefly mentioned in a note previously. I broke into my buddy's stuff and took one of these blessing pills out. I put it on my tongue and in that very moment i converted. Another time i was in the hospital at 23.5 hours of amio... They were going to zap me. I received a call just before they were going to wheel me out of the room. It was my own teacher, a great Tibetan master...i told him they were gonna take me to shock me... He said that i was not to let them because this time it wouldn't go well. He then had me do a prayer/visualization practice (in Tibetan Buddhism visualization is a very integral part)... As i was listening to his voice over the phone taking me through this practice.. just moments before i was to get shocked, at the very last moment .. i converted. His blessings worked. Everything may be coincidences... But i don't think so. 😉
Maybe blessing pills is all we really need, or I need to be a Buddhist. I did have your experience of converting once within minutes of being taken down to be shocked and wasting an entire day in the ER. I still have avoided being shocked so far in my 20-some years now of paroxysmal Afib. I usually get it on weekends, when I'm least stressed--go figure--and least likely to find a cardiologist.
Those pills were unbelievably rare and the lama who made them is dead. Other Lamas would come from all over the world just to get these pills from him. They took about 12 days around the clock to make them with a full retinue of monks and yogis in attendance doing continuous prayers etc. I got to see another Lama make them at his monastery in Bhutan. I left with a bag full of them but it wasn't from that lama. His were special. Nectar accomplishment medicine is the direct translation of the Tibetan words. Dutsi mendrup. I actually do have some but it's sealed in a copper reliquary along with other relics and holy things. Lol. I had to wash that great lama's rugs in a holy spring but before i did i scoured them looking for his long white beard hairs. Hahaha. We are kooks. I found a few and added them to another reliquary. Had you met this being i promise it would make sense. How to explain the presence of an enlightened being? But it's unsubtle and almost anyone feels it around them. Chinese soldiers wanted to arrest this one famous teacher in Tibet after the invasion. Every time they got within 30 feet of him they would just sit down on the ground and bask in his presence. They never did arrest him. I taught English to a lama who was this master's student in Tibet... He told me first hand amazing stories about him. He watched his teacher leave a footprint on/in a boulder... Like his foot into the stone until there was an outline in the stone of his foot. They practiced together on top of a mountain and a rain of flowers fell from the sky. I said, wow... And the lama said, not wow... Even a black magician can do such things, what was most amazing about my teacher was his compassion.
It's been my experience that paroxysmal afib is still mysterious to many cardiologists. So, I don't take it for granted that we necessarily receive correct advice. I've left the hospital AMA a few times over the 34 years until I found a cardiologist who would listen to me. For awhile only procaine would convert me but they stopped using it except for the crash carts. I would insist they take it off the carts and give it to me. Then they stopped listening and insisted on amiodarone for 23 hours and if that didn't convert me they wanted to shock me (which i hate...i don't like being knocked out with no certainty I'll wake up). My point being... Sometimes they're wrong. Often they're wrong. I'd be curious what dose of flecainide and how often you were taking? Or just to convert? Because at the wrong dose it doesn't do anything. 100mg twice a day is the dose that worked for me. Conversion could be 100-300mg. But usually 100 would work.
Flecainide works really well. Either to convert after going into afib (usually within 3 hours) or if you take daily you possibly won't get paroxysmal afib anymore. Maybe my next story will be about falling down a marble staircase in Nepal outside of a Tibetan Buddhist temple landing on my back breaking and dislocating my shoulder and the compression on my back caused me to go into AFib. You don't want to go to a hospital in Kathmandu for AFib. It was like the basement hospital scenes from Jacob's Ladder. Pure horror. So I had a broken shoulder and I was in AFib. No ambulance, some roads washed out from a storm which is why I slipped on a marble staircase it was raining. Good Times. LOL. That was before I knew about flecainide so I just had to pray that I would convert because they couldn't help me. I managed to call the US and my uncle the ER doc I mentioned in the comment below and this compassionate man said to me, that's what you get for living in a third world country. Wow. I wanted him to talk to the doctors there to tell them what to do for me. I just hung up dejected and fearing for my life again. Even for the broken shoulder all they did was give me literally a shoulder sling unopened in a box. Didn't even take it out didn't even put my arm in it. And before they would agree to treat me at all they said I had to consent to paying triple the local cost due to being an American. 😂 Then they held me for ransom when i didn't have a thousand dollars in cash to pay for the zero treatment they gave. Finally a friend gave her laptop to them to hold as collateral. Misty water colored memories! Hahaha.
Curious, is it WPW or just SVT/PSVT?
It was WPW...i was lucky to be able to be an experimental patient for the first trials of radio catheter ablations. I went on a 6 month waiting list and then had to fly to Oklahoma City where the doctor who invented the procedure was performing them at U of OK medical center. But since it was experimental they hadn't perfected it quite yet and even though they got rid of the bypass tract they left me with potential for afib. (And second degree burns from the multiple electrocardioversions throughout the 6 hour procedure. I was non responsive at one point so they just keep increasing the electricity... Topping out at 1200 joules for the zap that finally worked. But that much electricity burned me obviously. Better than being dead. Lol.)
I’m glad you got it correctly diagnosed and treated. I’ve taken care of a couple patients over 20 years with known WPW. Krikes! 1200 J? We defib at no more than 200 J on biphasic and upto 360 on older monophasic defibrillators, a fact you’re probably all too familiar with. My 1st location after school back in ‘03 was the cath lab at a very large academic hospital. Once a week, we’d rotate from cardiac cath rooms to the EP room where they did ablations for VF. Long cases ( upto 8 hours) and thankfully, we did them under general anesthesia so the patient wasn’t semi conscious for the duration.
Because catheter ablation was still experimental in '91 they weren't allowed to use anesthesia. So they had to give me an oral amnesic. I read the notes afterward and apparently I woke up during the procedure multiple times. But because of the amnesic I thankfully do not remember it. So it's probably just in my subconscious somewhere unknowingly screwing me up somehow 😂. The last thing I remember was when the nurse was shaving my groin to prep for the procedure and I suggested she should have at least bought me dinner first. Hahaha.
Thank the Lord for benzodiazepines.
Very intrigued to read this, and can't wait for the next part!
Thanks so much. 🙏
Please continue sooner rather than later 😉. Absolutely perfect title for this piece — riveting writing, very accessible.
Thank you kindly. 🙏