It’s been awhile since I wrote way too many words about something relatively personal. So strap yourselves in – or just skip this post if you’re not interested – for some old man news.
For the past few months I’ve been undergoing a series of tests to try to determine why I had two lengthy episodes of irregular heartbeat late last year.
The first episode was in October, the week that I was taking steroids and not sleeping because of my poison ivy. On a Saturday I had a few drinks at dinner with friends, a couple when they came over after, and just before bedtime, my heart started beating strangely. It was kind of a fluttery feeling, like my heart was out of synch. I had no chest pain or tightness, no shortness of breath, no numbness or anything else that would indicate a heart attack or stroke. S was already asleep, this sensation was not totally unfamiliar, so I went to bed figuring it would pass. I woke several times during night it was still present. Same in the morning when I woke up. I had checked my pulse with my Apple Watch a few times and it was always normal. I finally thought to use the ECG app, which told me I was in atrial fibrillation, the fancy word for irregular heartbeat.
“Well no shit,” I thought. I finally told S, she used her stethoscope to listen for herself, and then started looking up ways to counter AFib. I held my nose and blew out, like I was trying to pop my ears. I dunked my face in ice water. I ate cashews and drank cold water. Eventually my heartbeat corrected and I felt fine. When it didn’t happen again over the next several days and weeks, we both chalked it up to the steroids, lack of sleep, and alcohol combining to make my heart beat strangely for 12 hours.
Fast forward to mid-December. I was reading, about three sips into my only beer of the night. Suddenly I felt my heartbeat slip into AFib again. My watch confirmed. Stupidly, I just went to bed without telling S, thinking it would pass quickly. When the AFib was still present in the morning, though, I did tell her. She did some Googling and threatened to stick two plastic spoons down my throat. Apparently triggering the gag reflex can reset your heart beat. I refused because, again, I otherwise felt fine and wasn’t interested in gagging.
However, she was now concerned since I had experienced two episodes of AFib that both lasted over 10 hours. More importantly, my dad had AFib, and we believe he died because of complications associated with it. As soon as she got to her office she walked over to my doc on the family medicine side of her practice and spoke with her. They quickly got me an appointment with a cardiologist later that week.
So, two weeks before Christmas I began making rounds at medical offices. First came the trip to the cardiologist. Then one to my PCP so she could run some thyroid tests. Then came a heart stress test and heart echo. At that appointment I was given a heart monitor that I had to wear for a month. After the holidays I met with a sleep specialist and then did a home sleep study a week ago.
So, first, the good news: I aced all the heart tests. The stress test and echo – I walked and ran on a treadmill until my heart rate was over 150 BPM then laid down so they could shoot images of my heart – all showed my heart is healthy and functions normally under stress. Same with the heart monitor: it showed a normal, healthy heart. No thyroid issues, either.
I’ve also had no further bouts of AFib since December. Although my cardiologist told me to not make any lifestyle or diet changes while I was wearing the monitor, after the holidays I did almost completely cut out alcohol. It was more about needing to drop some pounds after the extra drinks and desserts of holiday break than heart health. But there was also the knowledge that alcohol may be a trigger for my AFib. On the nights I drink I do so nervously, waiting for my heart to slip out of rhythm. Since January 6, excepting nights we’ve gone out to dinner with friends, I’ve had maybe three beers. And then always lighter stuff rather than the 6–7% ABV beers I prefer. Hey, I’ve lost as many as nine pounds, too!11
I saw my cardiologist again last week and she was very pleased with all these results. She is sending me to get a heart scan, but other than that, I left without any prescriptions and without needing to see her again for a year. Provided I have no more AFib episodes.
My visit to the sleep specialist and resulting sleep study was to determine if I have sleep apnea. There are strong ties between sleep apnea and AFib. I bet you didn’t know that because I sure didn’t. This was viewed as more of a formality, as I don’t snore, neither I nor S have any memories of me waking up gasping for breath in the middle of the night, I’m not overweight, etc.
However, the sleep study was a damn nightmare. I had to strap a monitor across my forehead and then stick two tubes into my nose that would measure my breathing activity while asleep. They assured us – five of us picked up our monitors at the same time and got the spiel together – that we could sleep in any position. Well, I’m a stomach sleeper and you damn sure can’t sleep on your stomach with this thing on. I often fall asleep on my side, but even that was difficult with the monitor on. They also told us not to sleep around a partner who snores because the monitor could pick that up. S snores when she is getting a cold, which she was doing last week. So I decided to sleep in the basement guest room.
Between being forced to sleep on my back and being in a strange room I had soooo much trouble relaxing and falling asleep. When I did sleep, I managed to knock the monitor askew around 4:00AM, which set off an alarm that woke me to reposition it.
That night kind of sucked.
I got a call Monday saying that the sleep study showed that I indeed have sleep apnea. The specialist I spoke with two weeks ago said just because you don’t snore does not mean you can’t have apnea. And the more I read about the symptoms of sleep apnea, the more it makes sense. I’m always tired, even if I sleep well. I figured that was just because I rarely drink caffeine anymore but perhaps this is the explanation.
For now they’re going to put me on a CPAP machine for two months then reevaluate me. Unfortunately the sleep specialist doc is not in the office this week, so I don’t know if this is just a preliminary step or if I’m stuck on the CPAP machine forever. I’m holding out hope that it was a shitty sleep study that triggered the result and maybe I’ll only have to wear the machine for a couple months. I would not place bets on that being the case, though.
Here’s where those of you who have had real medical issues can laugh or shake your heads/fists at me: this really bummed me out. I’ve been a stomach/side sleeper my entire life. When I attempt to sleep on my back, I can never get comfortable and often jerk awake just as I begin to slip into sleep. And now I have to wear a device that forces me away from my preferred sleep position? A device I thought only elderly or exceptionally obese people had to use? That sucks.
As I thought about it more, though, I realized it is obviously a good thing to figure out what is causing the AFib so I can get it and keep it under control. While I don’t know many of the details of my dad’s final weeks, I’ve obviously seen how not managing your AFib can be a life ender. Also, as I noted, I had felt that sensation of an arhythmic heart before the October episode. I don’t know how many times or how often it has happened, but I know my heart has done that in the past. Just never for more than a few minutes, so I never really thought much of it. The lengthy episodes might be unusual, but the condition is not new.
Beyond the AFib effects, perhaps wearing the CPAP machine will mean I’m not walking around yawning all the time, or trying to not fall asleep when I sit stationary for a few moments during the day. It’s one of those things that has become so normal that I almost don’t notice it; in fact I don’t think I mentioned it to any of the docs, again because I assumed it had to do with the lack of caffeine in my system. But maybe I am exhausted all the time because I’m not sleeping normally, which is also triggers my genetic link to AFib and causes my heart to wig out occasionally. Wild, man.
So this all sucks. But at the same time it doesn’t. I am making some lifestyle modifications. But my overall good health has been confirmed. There are worse outcomes for having heart issues. There are far more serious diagnoses than sleep apnea.