Heart Attack to 10K (part 4.21) - Stuck in reverse (recap of 2022)

 Part 4.21 - STUCK IN REVERSE (RECAP OF 2022)

(Phase VI - sustaining a healthy life-style)

"Nothings going to happen unless you make it happen."

I would normally do an end of year blog on the anniversary of my first cardiac rehab heart assessment on the 31st January 2017, but 2022 has careered so far off the path I set myself that's it feels like I've been going backwards - negating a lot of what I have achieved, so I felt compiled do a re-cap of the past year just so I have a personal log if nothing else. It's been a disrupted year where due to a deteriorating heart rhythm, my exercising and running levels suffered significantly and consequently I've got a bit porky undoing 5 years of weight loss and I've been getting a little too near for comfort to my heart attack weight again.

I shall try and keep this blog brief but it has been one helluva year.

After 2020 where I had to several hospital appointments (not all cardiac related), for my 2021 new year resolution I set a target to stay out of hospital and miraculously managed to do just that with zero appointments throughout the year, but that not to say that my condition wasn't slowly getting worse and by contrast managed 23 either in-hospital or phone consultation appointments during 2022.

By January 2022 I was getting worried enough to raise concerns about the increasing frequency of my AFib episodes [see part 4.17] and was again referred to the cardiologist for further investigations. In early March I had an echocardiogram which gave favourable results with an ejection fraction (measurement of the blood pumped from the heart with each heartbeat around the body) of 60-65% (normal 50-75%) though grade 1 diastolic dysfunction was noted. Apparently this occurs when the left lower chamber of the heart (the left ventricle) has trouble relaxing in between beats because it has stiffened over time. It interferes slightly with the heart's most important job—getting oxygen-rich blood to the rest of the body which might explain a few things, especially while running.

As covered in my last blog [see 4.20], on returning home from the MK Dons League 1 play-off match at the beginning of May I went into an AFib episode which was to last for next 88 days, taking me over the 7 day threshold and into 'persistent' AFib for the first time. Up to now the average duration of an episode would last 40 hours and would typically return again after about 17 days.

During this period I had another trip in an ambulance to A&E at Stoke Mandeville hospital once more with chest pains; had a 24 hour cardioSTAT ECG monitor which showed AFib throughout and further phone consultations with my cardiologist before having my first DC Cardioversion [see part 4.20] in early August, this is where they zap your heart with an electrical current to try and reset its rhythm back to normal, it took two shocks out of a possible 3, but was successful.

Over the next couple of days I never really felt any better than before remaining very fatigued and tired, though it was good to see a ‘normal sinus rhythm’ on my KardiaMobile again [see part 4.17]. As I got ready for work on the Monday morning 3 days later I took another Kardia, this time it was showing a normal rhythm but with a regular ectopic beats, but the heart rate was a good steady 56, so I went into work. As soon as I arrived at my desk, my blood pressure shot up to 160/102 and heart rate elevated to 126 and lo and behold the Kardia showed ‘possible atrial fibrillation’, so I was out of AFib for all of 87.5 hours! A visit back to the cardiac day unit confirmed my readings and they increased my dose of the ‘drunken zombie drug’ Bisoprolol from 1.25mg to 5.0mg to try and control my higher heart rate.

a year of hospital appointments

At the end of Sept I was again back down the hospital this time for my 4th coronary angioplasty. It was nice seeing some of the staff in the cardiac day unit again who treated like an old friend but the angioplasty, performed by the same cardiologist who carried out my first angioplasty back in 2013, was probably the worst chest pain I have ever experienced.

map of my heart

The first stent (4th in total) was OK, I was told to expect some pain while they ballooned the artery and it disappeared once the stent was inserted which was uncomfortable but tolerable, the second where I believe they opened up an existing stent the heavy dull pain right across my chest didn't go and I had to be given morphine in the catheter lab and further painkillers back in the day unit until it settled.

The pain must be similar to that of a heart attack as the balloon blocks the artery simulating a heart attack situation but this was far worse than my actual heart attack, the cardiologist thought this was a good sign that they had found the right spot but for me it was a touch worrying - thoughts of being one of the 1/1000 to suffer serious complications flashed through my mind.

A whole new cocktail of tablets for at least the next year.

This doesn't fix my AFib problem which is still on-going and as I write this (1st Jan 2023) and has lasted 146 days so far, it will probably continue until at least my next cardioversion on 26th January 2023

Following on from the angioplasty I never really felt any better suffering with a chest infection which then turned to my first case of Covid towards the end of October (yeah, it got me at last! - but I am fully vaccinated and recently had a booster). I had to wait at least a further 4 weeks following this before I could be started on a delayed course of Amiodarone at start of December, this is a particularly 'nasty' drug which could be life threatening causing permanent damage to your lungs and loads of other unpleasant side effects (see list below) but is very effective in combating arrhythmia - it’s not something you want to be on long term though. Providing I respond well to my next cardioversion and this drug is successful on keeping me out of AFib then eventually I could be looking at an ablation (video), but I understand there is a year waiting list for this and I'm not keen on running the risks from this drug for any longer than I have to.

UK government patient alert card.

While all this is going on I was referred to an Urologist as my PSA (prostate-specific antigen) was raised again hitting 6.8 in Oct (slightly higher than it was at a peak 5 years ago), this led to me being put on Finasteride which should help with the night time peeing and reduce the PSA level. Other treatments also included an Ultrasound scan which confirmed an enlarged prostate and another MRI scan to disregard the possibility of cancer, which I’m still waiting the results. In a repeat of 2017 [see part 4.1], in the unlikely event that a biopsy is required it will have to be delayed until I come off the anti-coagulation in just under a years time due to the risk of serious bleeding.

complete parkrun record

All this has really affected my running and basic exercising throughout this year though I have tried to keep up a minimum level by at least regular walking and getting down and walking/jogging the local weekly parkrun when I could [see part 4.20]. Recently I have started on the cardiac rehab programme for the 3rd time which has given me more confidence to start upper body exercising again, something I have avoided since the persistent AFib began.

I always like to try and put a positive spin on these blogs but this year has been like I'm stuck in reverse which has been very frustrating - knowing where I was to where I am now. But hopefully, providing I start moving forward, there is a light at the end of tunnel and plan in place. The cardioversion can’t come quick enough (even if it means missing the Wycombe v Oxford football match) and from there I hope to get back to achieving what I was maybe a couple of years ago, the long term goal is then an ablation as a more permanent solution and to get off the 'nasty' drug.

comparison in distances (km) ran between 2021 & 2022
(red markers are when I've been in AFib)

Amiodarone Side Effects:
(I have seen these listed on several different web-sites and read many horror stories, I realise that you only get to see the bad/more serious cases on forums but it is still a worry)

• Lung toxicity is common (between 10 and 17%) and can be fatal; symptoms may include wheezing, difficulty breathing, fever, shortness of breath and coughing up blood. Pulmonary fibrosis is a very serious complication of amiodarone therapy.
• Liver damage, liver enzyme elevation, hepatitis.
• Worsening of irregular heart rhythms, Torsades de Pointes (can lead to sudden cardiac death), slow heart rate.
• Thyroid disorders, hyperthyroidism, hypothyroidism, thyrotoxicosis.
• Serious visual disturbances, loss of vision, optic nerve damage, blindness.
• Fatigue, tiredness, unsteadiness, dizziness.
• Tremor, hand shaking.
• Nerve tingling in extremities, burning or pain in fingers and toes.
• Digestive distress, nausea, loss of appetite, vomiting, constipation.
• Deposits in the cornea of the eye.
• Heart failure.
• Discoloration of the skin (a blue-grey tinge).
• Rash, skin reaction (requires immediate medical attention!), skin sensitivity to sunlight.
• Pancreatitis, liver damage.
• Hallucinations.
• Blood disorders.
  

UK government web site, drug safety update: Amiodarone (reminder of risks of treatment and need for patient monitoring and supervision) ... link

Heart attack to 10K pictorial record - click here

Thank-you for reading and I would love to hear your thoughts on any subject I have covered, please leave your comments below or email me at peterjemmett@aol.com

My full story - from heart attack to half marathon:

Part 1 - That fateful day. (Phase I - heart attack)  click here
Part 2 - Back home & drama at White Hart Lane. (Phase II - home recovery)  click here
Part 3 - They tried to make me go to rehab, I said yes, yes, yes please. (Phase III - cardiac rehabilitation)  click here
Part 4.1 - Getting FFITer and Harefield & Heartbreak hill revisited (Phase IV - sustaining a healthy life-style)  click here
Part 4.2 - Walking for heart & soul & finding parkrun (Phase IV - sustaining a healthy life-style)  click here
Part 4.3 - End of year 1 round-up and assessment (Phase IV - sustaining a healthy life-style)  click here
Part 4.4 - Falling heart rate: fitter or hibernation? (Phase IV - sustaining a healthy life-style)  click here
Part 4.5 - Pain in the bum, going senile and sub 30! (Phase IV - sustaining a healthy life-style)  click here
Part 4.6 - Sub 29, attack of the AKI and 1 year old (Phase IV - sustaining a healthy life-style)  click here
Part 4.7 - Pushing the boundaries (Phase IV - sustaining a healthy life-style)  click here

Part 4.8 - Bling, bling, bling, two 10K's and a 5K. (Phase IV - sustaining a healthy life-style)  click here
Part 4.9 - 3 Years On, Ragged Radnage and Pete's bolus journey (Phase IV - sustaining a healthy life-style)  click here
Part 4.10 - Coping with COVID-19 and what they say (Phase IV - sustaining a healthy life-style)  click here
Part 4.11 - Living in the lock-down (Phase IV - sustaining a healthy life-style)  click here
Part 4.12 - Plus and minus 3.5 years; heart attack to half marathon! (Phase IV - sustaining a healthy life-style)  click here
Part 4.13 - Is it worth the risk? (Phase IV - sustaining a healthy life-style)  click here
Part 4.14 - Mixed bag through Covid (Phase IV - sustaining a healthy life-style)  click here

Part 4.15 - Getting back in the groove (Phase IV - sustaining a healthy life-style)  click here

Part 4.16 - Reintegrating back into society (Phase IV - sustaining a healthy life-style)  click here

Part 4.17 - Get that crazy rhythm (the low down on AFib) (Phase IV - sustaining a healthy life-style)  click here
Part 4.18 - The 5 year itch, time to cut the CRAP! (Phase IV - sustaining a healthy life-style) click here
Part 4.19 - The last word (Phase IV - sustaining a healthy life-style) click here
Part 4.20 - Persisting with parkrun (Phase IV - sustaining a healthy life-style) click here

 

Next:
Part 4.22 - Starting all over again 6 years on (Phase IV - sustaining a healthy life-style) click here

Part 4.23 - God bless the NHS (Phase IV - sustaining a healthy life-style) click here

Part 4.24 - What I can, when I can (Phase IV - sustaining a healthy life-style) click here
Part 4.25 - Life changes (Phase IV - sustaining a healthy life-style) click here