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Be still my beating heart...

Atrial Fibrillation

Mon, Jan  30, 2012 - By Mike Muha

Atrial Fibrillation and cross country skiingBe still my beating heart… Well, maybe not still, but I’d sure like to have a resting heart rate well below my current 83 BPM. I remember the days, a few months ago, when it was down in the low 50’s, a fond memory.

Well, I’m having it fixed. Again. With surgery.

If you need the back story in my struggle to control Atrial Fibrillation, see

Friday, December 2, 2011

I’ve had my third Cardioversion in two days with Dr. Kim C Man at Beaumont Hospital. Electrode pads are placed on your chest and back and a shock is administered to “shock” your heart back into normal rhythm. As you know from “Third shock's the charm”, the procedure worked…

…To a point: Two weeks later I could tell that I was out of rhythm again.

Insurance

I realized all along that I was going to need an “Ablation” to take care of the problem. As doctors are, however, they like to try more conservative treatments first, thus the Cardioversion. The ablation procedure takes 4 or more hours and requires an overnight stay in the hospital – big bucks that I don’t want to pay out of my pocket. Thank goodness I have good insurance: Blue Cross Blue Shield!

But Beaumont hospital had a notice saying their contract with BCBS expired on January 1, 2012, and that patients would need to make alternative financial arrangements, i.e., pay out of pocket.

Not a chance.

I went looking for other doctors.

Friday, December 23

I met with Dr. Fred Morady of the University of Michigan, the same doctor Ken Dawson used for his ablation. I had an EKG which indeed showed I was out of rhythm: an Atrial flutter – so not as bad. He agreed an ablation was the next step and said he could get one scheduled…in 4 or 5 months. But I could get wait-listed for a cancellation. Fat chance of that…

Not what I wanted to hear. I wanted to get it done ASAP. The same day, I went to Dr. Man’s office for a follow up. He wasn’t in, but his staff talked with him and he came to the same conclusion ablation. So I had a concurring second opinion. That’s good. And he could do the procedure in mid-January. That’s good.

So the choice was: Dr. Man, no insurance, near instant gratification vs. Dr. Morady, insurance, long wait.

I went with option number 3: Find another doctor. Another skier recommended his ablation doctor at St. Joe’s in Ann Arbor. I called and got an appointment for February 15, with the ablation a week later. Better!

A week later….

In a matter of a couple hours, two things happened: First, I found out that I WAS covered by insurance at Beaumont Hospital! It turned out the expiring contract was with the Blue Cross Blue Shield HMO. But I was on the Blue Cross Blue Shield PPO. So I could use Dr. Man.

Second, Dr. Morady’s office called and said they had an opening on January 31.

What to do?

Everyone I talked to said to go to UofM because they had a dedicated Atrial Fibrillation clinic. Both doctors (although I didn’t know it at the time) were judged two of the best doctors in the region by their peers.

I decided to switch to Dr. Morady based on Ken Dawson’s experience and the recommendations of others, and because my wife felt more comfortable with Michigan. I’m sure Dr. Man would have done an outstanding job, however.

Impact on training

Dr. Morady continued the treatment with Pradaxa (blood thinner) plus had me on an antiarrhythmic drug. I don’t know if it was just the AF or if it was also the drugs, but I pretty much had to stop most training. After a full day of work, I was tired. There was no energy to train. Having a resting heart rate of 83 certainly was a factor.

I did go north for Eli Brown, Cassidy Edwards and Nick Baic’s two-day ski clinic after Christmas. Well rested, I survived the training, but my heart rate skyrocketed as we climbed long gentle hills. I could not go slow enough not to go under. I had to stop once or twice on each climb to catch my breath. But it was great to be on snow!

The first two weeks of January were totally exhausting with work, the NordicSkiRacer web site and preparing for the Frosty Freestyle and Krazy Klassic races. Early mornings and late nights were the norm. Energy for training? Zilch.

After the races were over, I did get some skiing in at Huron Meadows Metropark (thank goodness for their snow guns or it would have been on rollerskis). The first weekend I did lessons on both days, so it was a lot of stop and go skiing. On Sunday, I finished by skiing a 5k loop with teammates. Things started out great, but I slowly dropped back and then off the backend. They were going at an easy pace and I couldn’t hold it.

This past weekend, I did intervals at Huron Meadows with Tony Percha and Doug Heady. They were fun. I got crushed. At a dead easy ski, my heart rate was at 86% of max. A dead easy ski and I’m going my marathon heart rate. Intervals? I looked at my heart monitor and saw 113% of max.

I could ski fast, but only for a very short distance. After that, my heart rate zooms up and it’s very hard to get it back down again. Of course, you can’t ski long at 113% of max.

Justin Andre asked why I wasn’t at the Cote Dame Marie. Now you know…

Tomorrow, what's been happening in January, including a big afternoon at the MRI center. And just what is an ablation?

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