OT: The Dutch way with atrial fibrillation

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Here in Canada they just make you wait in line until you "recover" (i.e. leave the emergency room for one reason or another, possibly dead).

-- Joe

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Did you ask the doc about the voltage, duration and current for the first and second shocks?

Then maybe rig a 555 to do it at home?

Just kidding. Glad to hear you survived.

Michael

Bill, My Dad told me that when he was in medical school they called a-fib "old heart," figuring it was inevitable, even normal with age. It needn't be.

The base cause is usually clogged coronary arteries near the sino-atrial node, which starves the wet-ware heart-clock generating electronics there of oxygen (ischemia) and nutrients. That makes them a little flakey.

Fortunately you've got redundant timing facilities, so a-fib is usually just a nuisance, knocks your pumping capacity down 20% or so, makes you tired, but is not especially dangerous. Lifespan isn't affected.

You can often reset an a-fib yourself with a valsalva maneuver (hold breath and bear down), and omega-3s are valuable as well.[1] (use extreme care though, since you're on anti-coagulants. Fish-oil is also an anti-coagulant, and may potentiate existing meds. Any supplementation would have to be coordinated with medical supervision--you don't want to stroke out)

You might also evaluate your magnesium intake. It's vital for proper rhythm, present in whole grains, and deficient in many diets.[2] ISTR some buzz that the ratio of Ca to Mg is what governs, and that supplements are not preferred. You might want to Google it.

So, me not being a doctor, that's an engineer's guide to a-fib.

Cheers and good health, James Arthur

[1] e.g. [2]

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I certainly wouldn't use a 555.

And big electric shocks hurt - which is why they knocked me out. And if the second electric shock that is supposed to restart your heart doesn't work, it is nice to have hospital handy filled with people who have been trained to use other techniques.

If you watch "House" you will be aware that any medical syndrome can have all sorts of different causes. I went into the hospital thinking that I knew the most likely explanation for the symptoms that I was aware of, but fully conscious that something else might have been going on which I lack the training and the educational background to perceive.

-- Bill Sloman, Nijmegen

It sounds like the Dutch Way is to be pushy and persistent to get treatment. And at that, it took you a lot of calls and a lot of time. I wouldn't want health care like that for my employees, because I know that some of them don't have the personality to be that pushy.

If one of them called or emailed their primary physician with a problem like that, they'd be told to come in right away. That would cost $5. If they went directly to the ER on their own, they *would* be promptly treated, but that would cost $25.

John

Cause? I noticed this was posted about the same time I did my post on blood pressure:-(

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Dirk

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This happens to you a few more times and they'll have to give you the same cure they gave Dick Cheney. An implanted defirillator and the need to consume the souls of a few thousand innocent victims every so often.

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THE CURE FOR EXPERIENCING GLOBAL WARMING IS VERY SIMILAR. THEY USE ELECTROSHOCK ON THE HEAD, AND WHEN YOU COME AROUND YOU USUALLY ARE NO LONGER BOTHERED BY IT.

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My younger brother - who is a general practitioner - tells me that it is almost always controlled with medication these days. I'm going to have to up the dose of the stuff I take, which I could do without.

That doesn't seem to be my problem - I do have a leaky aortic valve, and the heart wall is getting thicker. It will be some years before they do anything about the valve, and I may die of something else before then.

The stagnant blood in the corners of your upper ventricles is a potential source of clots. Strokes and deep vein thrombos are more commin in a-fib patients.

I know the manoeuvre. It makes the aorta look strikingly different on ultrasound scans, and we used it when showing off our phased array scanner when I was working on diagnostic ultrasound at EMI 1976-79. Didn't make any difference to my heart rhythm when I last tried it.

I'm not on anti-coagulants, and would prefer to stay off them - it takes ages before they get the dose that gives the right clotting time.

If my doctors don't bother, I'm not going to get excited about it.

-- Bill Sloman, Nijmegen

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Three calls isn't a lot of time. The advantage of being pushy was that I got the electro-cardio conversion done before there was any real risk of circulating clots.

I could have gone directly to ER, but I'm registered as a cardiac patient, and my guess was that I saved a few hours of sitting around by by-passing the general emergency reception.

-- Bill Sloman, Nijmegen

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org/- A UK political party

Our= podcasts on weird stuff- Hide quoted text -

Probably an indirect side effect of my leaky aortic valve.

-- Bill Sloman, Nijmegen

Nor do you notice the difference between upper-case and lower-case letters.

I don't think that all denialists suffer from brain damage, but brain damage does make it more difficult to get one's head around the persuasive, but complicated, scientific evidence for anthropogenic global warming.

-- Bill Sloman, Nijmegen

[snip]

Yes, higher risk of stroke, but still trivial wrt mortality.

Wafarin--it wasn't clear whether you got it.

They'll usually take their lead from you--after all, it's your heart. If you won't bother, why should they? Your discomfort isn't bothering them.

Best luck, James Arthur

Slowman should worry. He's on socialized medicine. What net worth does he have to society? None. So he goes to the back of the queue. He should be proud his system works so well ;-)

...Jim Thompson

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| Analog Innovations, Inc.                         |     et      |
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Obama-Nazi only visits Washington when he needs to change his suit

I noticed the actress who hit her head learning to ski in Quebec was transferred to New York for treatment.

That's a rather stunning move for such a serious injury, where time is absolutely of the essence.

Unfortunately, she died.

James Arthur

If I'm lucky, I'll get what Arnold Schwarzenegger got - the Ross procedure.

Since my primary problem is "vegetation" on one the three flaps of my (tricuspid) aortic valve, and the arythmia is an indirect consequence of this (the neck of the aorta and the adjacent muscular tissue get progressively thicker as they have to work harder to compensate for the leakage through the imperfect valve) the surgery to fix the valve should also fix the arythmia.

I may be being a little optimistic here.

Since I don't seem to have any noticeable coronary artery disease, I'm probably in an different catagory from Dick Cheney, but I'll keep on eating the garlic. just to make sure.

-- Bill Sloman, Nijmegen

As usual, Jim's a little out of touch with reality. The Dutch medical insurance system is basically the same scheme that Bismark introduced in Germany (the Health Insurance Act of 1883) to undercut his socialist political opposition.

There are a number of competing insurance companies from which I could have bought my health insurance - having the health insurance is compulsory, but the administration doesn't care which one - so the whole deal is rather more "free market" than Jim seems to think.

I wasn't sitting in any kind of queue yesterday - or a least none that I was aware of - and I seem to have been looked after pretty quickly

On Thu, 19 Mar 2009 20:20:01 +0100, "Bill Sloman" wrote:

:When I woke up this morning, I realised that I was in atrial fibrillation :again; irregulatr heart-beat, and going upstairs to my study made me :breathless. : :Last night I'd noticed that getting up the stairs to my study was suddenly :hard work, so I figured that it had set in earlier that evening. : :It is easy for a cardiologist to fix it - they knock you out with a fast :acting anaesthetic, stop your heart with a big electric shock, and start it :up again with a smaller shock, and the heart almost always starts up beating :regularly. : :The catch is that if they don't do it within 48 hours of the onset of :fibrillation, your blood gets to pool in the stagnant bits of the upper :chambers of your heart (the atrium) and forms clots, which would get spread :around the body when the heart was shocked back into normal rythm. : :This is also fixable. They give you rat poison - wafarin - for about six :weeks, until they are sure that your blood-clotting time is about three :times longer than normal, and any blood clots are too soft to produce a :stroke or deep vein thrombosis, and then - and only then - do they give you :the electric shocks. : :So I spent the morning ringing my GP - who couldn't do anything, but likes :to have his authority acknowledged - and then the hospital that looks after :my heart. It took two phone calls before the assistant who answers the :relevant phone got to understand why I wanted my electric shock today, but :she then gave the cardiologist the right message, and I was given the okay :to go to the cardiac emergency room at the hospital. : :I got there at three in the afternoon, and spent two hours lying around :while they measured everything that they could think of - and even X-rayed :my chest - before deciding that they agreed with me. : :They knocked me out at five, and when I came to at about 5:30 pm the problem :had been fixed. I had to lay around for another half hour to prove that :there weren't any residual problems from the anaesthetic, and I had to hang :around for a little longer before my wife could pick me up, but I was home :again at 6:30pm, and had no problem with the stairs up to my study. : :And it won't cost me anything - beyond what I already pay for my compulsory :(and universal) medical insurance.

Here is the information sheet on AF issued by the Heart Foundation (Aust)

Apparently you underwent what is known as Electrical Cardioversion. There is also an alternative method known as Pharmacological Cardioversion.

Having sporatic irratic beats over the years, I first found simple additive calcium suppliment (Tums) cured that problem. Many years later the problem stated to reoccur. I found additive Magnesium suppliment up to 500 mg a day fixed that. I know a lady doctor who was running and developed bad beats. She ran a test and found low calcium. That was a while back. I also suggested trying some magnesium recently. Lately with hip problems, I am taking the recently updated levels of vitamin D and other suppliments. Works!

greg