Darn, darn, darn!`

I know quite a bit about the operation of the human heart. Mine acts up. I have an irregular heart beat, it consists of something called premature ventricular contractions, pvcs and premature atrial contractions, pacs. I've had this condition for years although it was first diagnosed in 2000 at a Jackson, MS clinic. Once I was able to associate the sensation in my chest with what the doctor found on a EKG I realized I'd had that sensation for years before 2000. I did not give it much thought. As the result of the diagnosis in Jackson I underwent a heart cath procedure to see if I had blockage. I did not. So I was told the irregular heart beat is common and benign.

Fast forward to 2007, I underwent the stress of having a cancer diagnosis and successful removal of about six inches of my exhaust system to eliminate the cancer. Nonetheless to be told you had a malignant tumor creates a great deal of inner turmoil. Three months after the bowel resection I ended up in the local hospital with an A-fib episode which is a very irregular heartbeat. Once cleared up, I did take some medication for about a year until another heart specialist called an electrophysiologist or EP weaned me off the meds and I continued to march.

Monday morning, August 17 about midnight I woke up with that "old sensation." A-fib. I rolled over and went back to sleep, that is how numb you get to the problem after a while, and when it persisted for about 6 hours I told Terry that instead of going to work she and I were going to Jonesboro to the NEA Hospital emergency room. This is my fourth visit to this facility in as many years.

I was in A-fib and placed in observation for 24 hours. The problem still persisted after 24 hours, so I was admitted and moved to a private room. About 2:30 AM August 19 my heart converted to a good solid sinus rhythm. I was released and sent home with two new medications called rythmole, which I have taken before, and Cardizem which I have not taken before. I will probably be on these two drugs for the rest of my life. That is a sobering thought. I don't know why so much, Terry is a diabetic and takes insulin just ot stay alive. I take a blood pressure med and a cholesterol med, but I think of that as a part of life. I do not like the idea of a heart arrhythmia. Not that it is so scary, but I feel like I am being forced to give into age.

I am not happy with this situation, but quite honestly I did not get put on blood thinners yet. I hope I do not have to. In talking with the cardiologist I was told I have a slow heartbeat. The two new meds reduce the heart rate. I was told by the cardiologist that if my heart rate slows too severely I will have to have a pace maker to insure it keeps on a ticking. One of the interesting things is that a real slow rate is not a number, but is how you react. If you start having troubles rising from a seated position, or bending makes you dizzy or pass out, then that is too low a number.

None of this is doom or gloom. However, it is indicative of the aging process and I am very aware of that. So my heart is in actuality strong and will last a lifetime. It just needs some help. In the meantime my brain is dealing with another issue that marks the passage of time and the appearance of finality. Darn, darn, darn.

Motives?

I participate in a forum for those who encounter irregular heartbeats. I have learned a great deal, not only from reading medical materials but from the many members of the forum and their personal experiences. Over the year and a half I have participated there seems to be a pattern. A person typically has some large stress event in their life, they become conscious of the irregular heartbeat, they are extremely frightened by the experience and find the forum where they get reassurance they are OK. The person undergoes what I now recognize as standard tests, EKG, Stress Echo-Cardiogram, Holter Monitor, perhaps an cardiac catheterization, and other tests that check out the structural integrity of the heart. They are almost always told they are OK, the irregular heartbeat is benign and they should try to ignore the sensation. Eventually everyone seems to come to terms with the condition.

You do find the occasional person who says they are not overwrought by the problem, but take a logical approach trying to determine first what causes the onset and second what they can to do prevent the onset. I have found many of these people seem to underestimate the impact of stress on our lives. I find some people who are dead set against any form of medication. I also find persons who seem to be on a never ending quest for some natural solution, zinc imbalance, potassium, magnesium, omega oil, and on and on. I end up feeling bad for these people. It seems as though they find meaning in life by searching for a cause/cure. I am convinced irregular heartbeats are benign and will not hurt me, so I've chosen to get on with my life. Others seem to spend endless energy in their search when there may be no answer.

I've recently seen another behavior I wonder about. I have encountered some people who talk about exercise and workouts that seem to be intended to stave off aging instead of enhance the quality of their life. I recognize the last statement could be considered a contradiction of terms, after all if I do stave off aging am I not improving the quality of my life. Normally I would say yes, however I find there is a possible difference in the motive. I find my exercise routine enhances my enjoyment of my daily living. A few people I've encountered seem to look down the road past today and be wrapped up in exercise as a means of creating immortality and forget to enjoy the daily life experiences. I wonder if they ever come to terms with that drive.

A year later

Well it has been just over a year since I had a bowel resection. Today, I feel very well. In November of 2006 my Family Dr. wanted me to start taking insulin to counteract the high glucose levels I seemed to be sustaining. I asked him to wait three months and let me try to diet and see what I could do. Little did I suspect!!!

Later in November 2006 a colonoscopy revealed a "suspicious mass" in my lower colon that required surgery, it had gotten too big to be removed during the colonoscopy. So on January 9, 2007 I underwent the bowel resection procedure.

Recovery was tough, I was ill prepared for what I would go through and did not have a lot of information on what to expect. I talked to my surgeon's nurse quite often and she helped me understand what was taking place. I have documented a lot of what I went through earlier on this blog for those who wish to look back. Thank God for my sister who had uterine cancer and could shed some light on what I was experiencing, also my step daughter who is a surgical nurse and helped me understand the procedure. A great big thanks to my oldest daughter for her support and help. She even came to Arkansas and stayed a week to help me and determined I was dehydrated which helped me over come a real physical problem of having an upset stomach much of the day. Thanks to my oder sister who is a retired RN and could lend support from her knowledge base. Finally, thank God for my wife who stayed with me in the hospital, who cared for me at home, who kept talking to me and reassuring me that all would be OK. Recovery was tough, it would've been a lot tougher if it hadn't been for my support group.

Today, I no longer take any diabetic medication. I exercise by walking vigorously one hour a day, I have lost 60 pounds. My blood pressure has dropped back to normal, I am off cholesterol medication with the exception of Zocor. All of my cholesterol readings from several blood tests are well within the normal range. I am in the best health and best physical condition I've been in for over 20 years.

I went through a lot. I had the bowel resection in January, in March I had an atrial fibrillation attack that hospitalized me until my heart converted to sinus rhythm two days later. My previous diagnosis of premature ventricular contractions escalated into a real irregular heartbeat problem that darn near drove me nuts. I ended up wearing a holter monitor and taking a drug, rythmole, for what was perceived as a heart arrhythmia. In Oct, after much exercise and walking I got off the diabetes meds, dropped one cholesterol med, and because my heart pulse got so slow, like low 40's, the rythmole dose was reduced. In November my gall bladder was removed and I had to deal with some diet issues. All in all it has been a tough year, yet at the same time it has been a most uplifting year. I've lost a lot of weight, I am cancer free, my blood pressure is normal, my cholesterol levels are low, my stamina and flexibility are excellent, and I'm looking forward to a long and healthy life. As of January 2008 I am off rythmole and while I still experience an irregular heartbeat, it is lessening and is not much of a problem now.

You can change your outlook and you do have options.

Here is a success story

Approximately ten months ago I had a bowel resection. The "suspicious mass" was malignant, however it was caught so early that my prognosis is excellent. The oncologist used the word, "you're cured." Periodic colonoscopies should prevent further occurrence. That is not to say that some other form of cancer might rear its ugly head, but I fall into the same risk category as others who have not had colon cancer. That is good news.

Recovery at home was tough. However I have a number of essays in this blog covering issues that I encountered during home recovery that may be valuable information to others going through a bowel resection.

In addition to the surgery I am/was being medicated for hypertension (high blood pressure) high cholesterol, type II diabetes and atrial fibrillation. In addition I encounter an irregular heart beat. Some of that information is also documented in this blog.

Now after 10 months, numerous trips to various physicians I am able to report substantial progress. While I was undergoing home recovery my weight dropped significantly because of lack of appetite. The surgery was in January, in March I decided to continue the weight loss in the form of a calorie counting diet. I had lost approximately 26 pounds in the two month period since surgery. In addition in March I had an atrial fibrillation episode that hospitalized me for two days while that settled out.

Now some ten months after surgery I am able to tell anyone interest that I have lost a total of 60 pounds and dropped 4 - 6 inches off my waist line and am in the process of retooling my wardrobe. Everything from my hats to my shoes are looser. I am walking 40 to 60 minutes a day at a 3.5 mph clip. I have completely eliminated the Metformin and Glipizide I was taking for type II diabetes. I have eliminated one of the two hypertension medications and upon advice of a cardiologist retained one medication, fosinoprol sodium (Amapro) because it has been shown to reduce the risk of heart attack. My resting blood pressure averages 107/75 now.

I have dropped one of my two cholesterol medications called Tricor. Tricor targets triglycerides and my last blood test indicated my triglyceride level at 41 and normal range is 40 - 200. With that much upward room my physician agreed with me that eliminating Tricor is an acceptable risk.

My daily walking pattern had started to whip my heart into shape. As you may know as your heart becomes stronger your pulse rate slows down. The capacity of your heart to pump blood increases so the frequency it beats can slow. My pulse rate has slowed to the low 40's which my physician and I felt was too slow. To control the atrial fibrillation problem I was taking Lanoxicaps (digoxin) and a new drug called propafenone (Rythmole). The cardiologist told me to stop taking Lanoxicaps immediately after my physician called him to discuss the slow heart rate I was encountering. The cardiologist made an appointment for me to see another cardiologist that specialized in the electrical performance of the heart. When I saw this new physician and he learned that I had only had two A-Fib episodes in the past 18 - 20 years he basically said you do not have an atrial fibrillation problem. Two episodes in that period of time do not constitute a heart arrhythmia but are considered lone episodes whose cause is unknown. I know what the cause was, those were two times in my life I was undergoing extreme personal stress. Regardless this new cardiologist agreed that dropping the digoxin was OK as he felt it had no therapeutic effect at this time. (Digoxin slows the heart rate.) This doctor also felt that the propafenone was not necessary. In fact, propafenone can contribute to heart palpitations or irregular heart beat. We are now weaning me off the drug, in three months I well wear a Holter Monitor for 24 hours and if there are no episodes of A-Fib then the propafenone (Rythmole) will be dropped. I believe that will be the outcome.

When all is complete I will be a cancer survivor. I will have lost over 60 pounds. I will have in place a regular exercise program to strengthen and maintain my heart. I will have eliminated the type II diabetes medication. I will halve the cholesterol and hypertension medication and eliminated the antiarrythmia medication. I will be left with an irregular heart beat that most people encounter, they just can't feel it. My heart palpitations have reduced already, the sensation has become almost imperceptible, and I feel the best I've felt in 20 years.

Only time will tell if I am able to maintain this routine. I intend to! I document all of my progress in the form of a spread sheet filled with blood pressure, pulse and glucose information. It is my method of obtaining positive reinforcement. I can say that I've come a long way, I feel good, and hopefully the follow-up colonoscopy in November will document the success of the surgery.

I have learned that it is necessary for you to take an active part in your health maintenance. Doctor's do not know all of your past history. The usual blood tests and various test for specific symptoms do not tell the full story. I have spent a lot of hours studying on the problems I was encountering and have learned a great deal. This has assisted me in asking intelligent questions and add specific information as it relates to "me." This has allowed the physicians I pay to assist me in my health maintenance to make more informed decisions. I am another of those who have learned through painful experience that you have to take charge of your own health, all doctors can do is advise on what they know. So good luck and take charge!

Week 34 Recovery

Things are going well. The Citrucel recommended by my surgeon some time ago seems to be helping my body regulate its bowel activity. In addition I've learned not to try too hard and have seemed to overcome the pain and feeling like I still had to go right after I'd gone. I am pleased with the progress.

My heart PVCs have calmed down some. I have still some episodes, they come in the morning, pretty calm during the day, then again at night. However the duration seems to becoming less and less and mentally I've made strides in accepting the aggravation as simply that.

The gas attacks I was having seem to have decreased volume and frequency. However, I still have poor control and end up making some noise as I move around my daily routine. Some funny, sometimes it embarrassing. All in all I think I've turned the corner and look forward to more normalcy in my life.

Crossing a New Bar

Well an interesting event seems to be occurring and I am the unwilling participant. Five months ago I knew I was past 60, however I still felt that I could lose weight, exercise and carry on as I had years ago. Then, a colonoscopy revealed a suspicious mass that turned out to be malignant. However surgery was successful, the malignancy had not spread and I was pronounced well by an oncologist. In the meantime I had a recovery to make, which was and is rather rigorous. Then eight weeks after surgery an old problem reared its head, atrial fibrillation, or arrhythmia. The last episode I had of that was 16 or 18 years ago. I have taken medication for all that time, but apparently the stress and trauma of surgery brought about a recurrence. Now I take another pill.

So what is this "New Bar?" I feel vulnerable to those things I thought were not of my time. Will my heart arrhythmia cause further serious problems. I have no heart muscle damage, my cholesterol is within limits, I've had two heart caths that indicated no blockage, and as recently as December as part of my pre-op procedures I had an stress test and echo-cardiogram that supported no blockages. I am sure my risk of serious heart problems rise above that of someone with no arrhythmia but should I feel so vulnerable. Perhaps time and getting used to the new rhythms will ease my discomfort. For now I feel age bearing on my shoulders.

Some Additional Episodes during Home Recovery

It has almost been seven weeks since surgery. I'd like to report that I am ready to take on all things in life, but that is simply not true. The pain in my abdomen has subsided, but I am still sore and get little jabbing reminders that something was done to me. The one irritating thing that seems to be somewhat relentless is my upset stomach. I am prone to gas after eating, not that I wasn't before the surgery but this is quite uncomfortable. I am taking chewable Gavascon tablets chased with a glass of water and that seems to be helping. Still I cannot seem to shake this nervous feeling in my stomach.

My bowels are not regular. I think they are trying, but I am running into constipation. I have the feeling of needing to go, but can't. I have strained myself, but the Doctor said don't. You could create a hernia in the incision in the lower bowel causing a problem. I am now taking a fiber supplement and a stool softener. The Surgeon made a real point of DO NOT take a laxative. It has been a couple of days taking the two supplements and it does seem to be working to some degree. However, I have no idea if and when I will return to comfortable regularity I once knew.

I am still weak and tire easily. As I have stated in the larger post I am not a sleeper, so when I nap it may be for 20 to 40 minutes. It does refresh though and I am grateful for anything.

I am taking an anti-biotic for a urinary tract or bladder infection. I experience some discomfort and once and a while a slight burning sensation when I go. The anti-biotic is having some effect, but not completely relieving the symptoms. However, the anti-biotic does have some effect on the body. It says you may become dizzy, light-headed, upset stomach, loss of appetite while your body adjusts to the medicine. I've been having an upset stomach for some time. I do not know if it is tied to the medication, the surgery, both or other things going on. I have to take the medication for 14 days, day 14 is tomorrow, hurray! I hope that my stomach problems diminish, it is getting me down.

Among the side effects is irregular heartbeat. I would imagine that most people without heartbeat problems would not experience this side effect. However, I have a history of arrhythmia and premature ventricular contractions. So I can't help but feel the increase in PVC episodes is due to the medication. I'll find out in a few days.

I think that recovery from major surgery is a healing process coupled with dealing with different episodes as you recover. I know I am a lot better than I was four weeks ago. I am no longer nauseous, I am getting out and about. I don't feel very good, but in the end I'm getting there.