Good News, Bad News
I used to have a 1966 Volkswagen van. It was the best vehicle I’ve ever owned. To this day I have dreams about driving it. It was white, with wings painted by the previous owner on the two forward doors. I bought it in 1980, just before heading cross-country to go to grad school at Northwestern University in Chicago. With the help of my girlfriend’s dad, who was handy with power tools, I rigged it so that I could quickly convert it from a cargo van to a passenger van to a camper. I slept in it often, both on the road, and after late nights of waiting out the doctoral students for my turn on the Communication Disorders department’s one and only computer, which in those days filled an entire room, and today would fit in your pocket. In the dead of Chicago winters, I sometimes woke up with a view from inside of a snow bank. I always drove that van in the right lane on the highway, figuring that it was likely to break down any minute, and I’d have easy access to the shoulder of the road. Despite my fears, the only time it failed me beyond my ability to tinker it back to life was during a vacation in Wisconsin, where it coasted to a stop, in the middle of nowhere, right in front of Smitty’s VW Repair. I spent the night in my van, in Smitty’s parking lot, waiting for the bank to open so I could get some cash, pay Smitty for a new clutch, and be on my way.
One of the best things about that van was that while you were driving it, you could never be in a hurry to get somewhere. You were forced into a zone of Zen patience and constancy. Speeding was not an option. I even made it over the Rocky Mountains--more than once--without any problems, but when I pressed the accelerator to the floor, it was more of a suggestion than a command. The van seemed to think about it for a moment, then gradually, reluctantly, it would spin up the revolutions and go, like an old man getting off the couch. On a flat road, it chugged along happily at 60 mph, but anything more than that made both of us skittish.
Since sometime before my first heart surgery in January, I have been avoiding stairs. Our bedroom is on the second floor, but if I forget something up there, more often than not I just decide to go without. It is hard to describe the unpleasantness that I experience. Initially I thought that I was “out of breath,” but that’s not it, because I wasn’t breathing hard at all. In fact, sometimes I would consciously, deliberately breathe fast and deeply, but it didn’t seem to make any difference. I think it is more accurate to say that I felt “out of air.” The weirder thing, as I tried to explain to my doctor, is that I can climb 100 flights of stairs, such as you might find leading up to a Buddhist temple on a mountaintop in Shikoku, and that doesn’t feel as uncomfortable as climbing just one. My doctor thinks I’m crazy, but he’s courteous and medically obfuscatory about expressing it.
I had the cryoablation procedure a couple of weeks ago. This was supposed to cure the atrial fibrillation I often experience during exercise, and which was an unfortunate side-effect of my mitral valve repair. Everything went well. The procedure usually takes between three and six hours, but mine took less than two. The surgeon attributed this to her observation that (and I’m not making this up) “your anatomy was perfect.” I’m putting that on my resume. The incisions were surprisingly tiny, things healed as they were supposed to, and the bruises are almost gone.
Something feels different, and I notice it on the stairs. The air hunger is less severe, and sometimes it is gone entirely. Sometimes I find that I can even bounce up the stairs, the way teenagers do, and I may be breathing a little harder when I get to the top, but I am not suffering.
I’m starting wonder if my old heart was performing like my VW engine: slow to respond, but getting there eventually. The cryoablation was like replacing that old four-banger with a more responsive sports car engine. Now I feel giddy going up the stairs. My default walking pace is faster too, according to my Garmin fitness watch. I can’t explain it, but the data is consistent.
That was the good news. The bad news is that after following doctor’s orders and waiting a full two weeks, I took my heart to the track for a little test drive. It crashed almost immediately. I’ve tried jogging a couple of times now, and have gone right into an atrial fibrillation episode both times. A set of pullups this afternoon produced the same result. These episodes tend to last longer than the ones I experienced prior to the ablation. My resting heart is higher also. It went from the high forties to the mid-fifties after the valve repair, and is now in the mid-sixties.
The surgeon stressed that the ablation procedure itself, ironically, could cause atrial fibrillation, and that if I do experience AF, it doesn’t mean that the operation wasn’t a success. Time will tell. Although there appears to be a positive correlation between afib after surgery and surgical failure, most doctors consider the first three months after surgery a “blanking period,” during which they basically assume that the ablation was the cause. In my case, I’m drawing hope from the fact that the afib feels a little different than it did before--longer in duration and perhaps with a lower average heart rate. On the other hand, the fact that exercise is still the trigger, and the trigger seems even more sensitive than before, is discouraging.
Anyhow, for now, it looks like running is off the table, along with other things that get my heart rate up there. Fortunately, walking seems to be in the safe zone, and the other day I got in a 10 mile hike with a 2500 foot elevation gain without any problems. So I’ll just keep walking. Like I’m training for Shikoku.
