Almost 4 weeks ago, I had an episode of atrial flutter tachycardia at the very end of the three-month post-ablation blanking period. It was mild and I didn’t experience the typical awful fatigue and brain fog. I felt okay. My HR was steadily 24/7 104bpm for two days, then 115bpm for four days until I had a CV that put me back in NSR, where I remain.
The day after the CV I had a consultation with the EP Nurse Practitioner. We discussed medications, deciding on PIP (which I have not had to use as I’ve stayed in NSR since the CV) and other things—much of which consisted of my bringing her up to date on my case
Here’s my issue:
When I read the NP’s notes of our consultation online a day later, I came across this sentence, quoting exactly: “I’m not very optimistic she can maintain NSR.” Wow. That was a bummer. It’s another way of saying she predicts that the ablation will be a failure and I’ll return to Afib.
So I got online to read on NIH/PubMed articles about reverting to Afib during the blanking period. I discovered that reverting near the end of the blanking period can be predictive of a return to paroxysmal or persistent Afib by six months out. Bummer. I was quite downhearted—even though in NSR and feeling fine.
But then….I decided to go back to the studies and take a second look. One of the studies reported that 76% of those who have Afib reversions during the blanking period are likely to revert to Afib by 6 months post-ablation.
First, I said to myself. What makes the NP think I won’t be in the 24% who don’t revert? Given my situation, I could easily, I believe, be in that 24%.
So next, I looked at the cohort, looked at who was being studied. I found a staggering list of people with co-morbidities: previous heart attack or stroke, high blood pressure, diabetes, liver disease, kidney disease, COPD, obesity, etc. That is not my cohort. I have no co-morbidities. Even my heart is healthy except for, as my cardiologist put it, “Good news! It’s just only Afib.” Predicting that I most likely was going to have a failed ablation based on statistics representing people very different from me seems to me an error of judgment. I am a cohort of one. I need to be seen as an individual and a whole person.
I am now starting to turn to functional medicine, for it sees each person as a cohort of one and the only relevant research in seeking healing that person is research into the substrate causes of that one person’s medical problem.
If I were in a research cohort, it would consist of people who eat a nutrient dense diet with lots of vegetables, fruit, and nuts; who in their 80’s walk 5000-6000 steps a day including hills; who have good sleep hygiene with no apnea; who meditate at least occasionally and mindfully practice mindfulness throughout the day; who manage stress well, including biweekly psychotherapy sessions; who have a weekly massage; who regularly see an acupuncturist, as well as a craniosacral therapist for TMJ and a PT for balance issues due to aging; who are engaged in their lives, physically, spiritually , socially active. And have two dogs and a cat.
What I’m trying to say here is that we can’t let medical people just casually file us away or put us in a box with a label:”Likely to fail.”
I’m also trying to say that there is much we can do to heal ourselves in ways that do not depend on pills and procedures, and those things matter and should be taken into consideration when medical personnel are evaluating a patient.
The NP who wrote she was “not very optimistic” about my chances for a successful ablation does not know ME. Her comments in her notes—comments which she had not said aloud directly to me explaining why she diagnosed probable failure—were, in my hindsight opinion, hurtful to my hopeful, positive attitude (which is important in healing) and ill-considered in their disregard for who I am as an individual patient, not just as a statistic and another old body with a medical center ID number.
What we don’t need when we travel this Afib journey is health professionals predicting failure without knowing the whole person, and speaking directly to that person and providing substantial evidence to support their negative evaluation.
That’s my tale. I have chosen to dismiss the negative prediction as simply poor medical practice. And meanwhile keep my fingers crossed real hard that I’m in the percentage who revert in the blanking period’s third month, convert, and do not revert again by six months or a year. 🤞🤞💓🎶 🤞💓