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Chemo and AFIB
I had my first AFIB attack in '05. A cardioversion lasted 10 years. Then I got it again after a streeful session with my Health Care Provider during Open Enrollment. Another cardioversion. Then I was diagnosed with Multiple Meyloma. Not much. Just starting up. Caught it early. Chemo was only pills. BUT those pills kept giving me monthly attacks, cardoversions and two ablations. The Dr and surgeon began to disagree as to treatments and now I'm looking at a third cardioablation. One says a pacemaker will keep me in NSR when chemo is restarted. The surgeon says, at 62, I'm too young, it is a last resort tactic and it is not indicated for AFIB. What to do? Tried three different types of chemo pills and infusions. I've begun to have attacks at home while OFF chemo. I self rescued with a teasoon of salt to bring the BP up and 2 liters of water and a Xanax to bring the pulse rate down. Any ideas would be welcome. Don
Jeanamo815, April 26, 2018 5:46pm EST
Mr. Don....I am sorry you are having problems with your chemo and atrial fibrillation. Dealing with both treatment for multiple meyloma and a-fib must be a difficult time for you. A pacemaker WILL keep your heart rate from being too slow (which can sometimes be caused with medication), but I do not believe it will control your a-fib...so I do not understand exactly why your physician has recommended that for you. A pacemaker does not prevent a-fib nor the fast heart rate that can sometimes be part of an episode. What medicines are you taking for a-fib? I assume you are taking an anticoagulant to protect you against stroke...such as warfarin, Eliquis, Pradaxa, or Xarelto. Perhaps there is some type of interaction between your a-fib medicine and the chemo. If your electrophysiologist...and the physician treating your multiple meyloma...think you are physically able to have the ablation procedure again, perhaps that will be successful in stopping the a-fib episodes which are happening now both in and out of chemotherapy. I am really not sure why the pacemaker was recommended for you. Perhaps you can get more information about this from your physician that will explain the reasoning. I know you are anxious to find a workable solution so that you can regain your health. Please continue to let us know how you are doing and what decision is made for your treatment.
Wishing you the best and a return to good health,
(My A-fib Experience Community Leader)
MrDon55, April 26, 2018 8:05pm EST
Thank you for the reply Jeanamo. Just got back from the electrophysiologist. I get a 6th Cardioversion on Wednesday, May 2nd. As you know, low BP and high pulse means AFIB. Average to slightly low BP and moderately high (but continual pulse in the 120's day and night) is A Flutter) That means another shock for me on Wednesday. If it does not work, I get the laser a third time. Both had medical mistakes by the staff, so I'm not looking foreward to it. 1st, the MA did not know what Invokana for my Diabetes II was. (It puts excess sugar into your urine) She neglected to tell me to stop it as a result. I ended up with a near-fatal infection from the cathater as a result. Wore a bag for a month.The Cipro can cause heart arrythmia so they could not give it to me. When we finally took the chance on it, I was cleared in a week. The second surgery, the Dr did not want to be on the "list" of people who prescribe pain meds. After a 7 1/2 hr surgery he ignored my allergy list and gave me a single injection of morphine that gave me a 23 hr blinding headache. He would not answer his phone when called. Thank God I had my "man bag" with my Diabetes kit in it. I quitely took my own Neuropathy pain meds to save myself. And now, I am looking at this all over again. I will draw up legal documents for him to sign if need be, that he will prescribe what my Pain Management Doctor recomends, or I will "go elsewhere" for my procedure. My cardiologist, I rarely get to see... just the PA. He and the electrophysologist disagree on the pacemaker. The PA took away all my anti-arrythmia meds and trippled my Metoprolol, as I tried to lower my pulse. I ended up at the electrophysiologist office. He reduced the Meto to 1/2 tab, added Diltiazem and Sotalol to my list. These two don't communicate as they are not in the same "group". I have to hand carry info, discs and records between the two. My list is Eliquis, Alprazolam (for tinnitus) Crestor, Metoprolol, Potassium, Androgel, Glimepride, Furosemide, Rapaflo, Prilosec, Metformin, Vicodin, Allopurinol and Cialis 5mg (urilogical med). No one in the surgeon's office understands why the Cardiologist's PA suggested a pacemaker. I am only 62 and that is a last resort that is not indicated for AFIB, I'm told. BUT the Cardiologist is 7 minutes from home and the electrophysiologist is over an hour away. The PA will communicate via text as well. The surgeon won't do this. I'm inclined to follow the electrophysiologist's advice. It has been a hard road with the medical mistakes he made and the bad advice given by the Cardiologist's assistant. I've been slowly walking our dogs around the neighborhood for almost 3 years now as I try to recover from each proceedure and batch of pills that are sometimes appropriate, sometimes not. The Oncologist plans on giving me an "Antibody" to go with Zometa infusion the next time and hope I don't go into AFIB once again. First failure was Revlimid and Dexamethasone. The Dex gave me the AFIB. Then it was Revlimid and Valcade injections. The Valcade did it the next time. Then it Polymast and Kyprolis and I was in AFIB again. The Oncologist can give me 8 to 12 years, he says. But if I keep getting AFIB ..... I have a decision to make. Live without the cancer meds as long as possible or risk death a lot sooner if my heart can't tolerate the chemo.
Jeanamo815, April 26, 2018 9:27pm EST
Oh, Mr. Don.....you do have a complicated case going on and I know you are faced with some hard decisions. It would be helpful if all your physicians were "on the same page" as to how you can best be treated for your multiple health problems. Not being a health professional, I really cannot make an informed comment about your health situation. You are taking a lot of medicines....some of which may or may not interact with each other. It is unfortunate that you've had several bad experiences with your procedures. That has no doubt created more anxiety for you to deal with along with the medical problems. What I can offer you is support from the members of this a-fib community who share our experiences and hope to provide encouragement. You will find that the people in this forum are genuinely caring and helpful. So please continue to share your concerns with us....and while we may not have the answers for you.....we want you to know that you are "not alone".
Wishing you the best and better health in the days to come,
(My A-fib Experience Community Leader)
MrDon55, April 27, 2018 1:57am EST
I do wish to thank you for the caring. Rite Aide Pharmacy has done an excellent job with not allowing me to pick up meds that interact with each other. They even alert me to meds that , if taken for a certain period of time, can do me harm. So, I am covered there. Tomorrow I start Yoga and Meditation classes. I figure if I can remain calm with all this going on, I'll have a better chance. I would like to know if any in the group have had AFIB as a reaction to chemo. I would like to offer some information to "the group". Remember, this is what worked for ME. Everyone is different. The Oncologist has tried four different chemo coctails and the best one .... Revlimid and Valcade injections he had to stop because it was doing nothing but holding the Multiple Meyloma at bay. No improvemenmt for 7 months. So, he changed it and I got another AFIB attack. Also, not being a doctor, the only method I have to detect AFIB is calculating it with my blood pressure meter. Say, if I'm 56/41 with a pulse of 165, THAT's AFIB! What I've learned is that I can raise my blood pressure with a teaspoon of salt, straight in the mouth until it melts, lay on the couch, cross my ankles, feet up and drink two liters of water. Within 30 minutes I can get the systolic over 100. If the pulse is stubborn and the couch doesn't relax me enough, I take a ONE Xanax (normally used for the ringing in my ears from an explosion at work back in '06) and lay there some more, drinking water. I've brought it down to 75 or 80 like this. I've also had it go the other way. Too high a BP. Again, the Cardiologist PA changed the Diltiazem the electrophysiologist had given me and substituted it with Lisinopril. I broke one of my own rules. "NO CHANGES OR PROCEDURES ON A FRIDAY!" The doctor is unavailable until Monday. Worse if its a 4 day weekend. I took my new med Friday afternoon and left for Vegas with my wife. I did not bring the old medication with me. Stupid of me. I got really ill. I was 200/97 pulse 76. The Lisinopril was doing nothing. I was out of state, without medical coverage in Nevada and the meds I had were as effective as throwing rocks at a Russian Army tank! Then I remembered something. The State of Nevada had wised up! They had legalized medical and recreational pot just days before. My wife drove me to the address she found on her iPhone and as I stood there in the long line, I checked my BP and got out my kit and checked my Glucose. The BP was still at 201 systolic. Glucose slightly elevated. I was weaving. One of the folks further up the line went inside and got me a folding chair to sit in. Soon, a fellow in a white lab coat came out, helped me inside, and waited on me. There was a special medical section of the counter he took me to, just like a pharmacy. He got out a binder, had me check my BP again, flipped through some pages and found what type was recommended. $45 got me a sealed packet with a Nevada tax stamp on it. Back at the hotel, I smoked an amount about the size of two BB's. That's ALL. In 15 minutes I was 127/62, pulse 81. Normal. Wow. Saved my neck. A trip to the ER would have been my next expensive move. However, it was not necessary. A year later, this won't work for me as I have A-Flutter and my pulse is a consistent 125 and the BP is a bit low. Any lower and the result would be AFIB, so medical pot would not be wise. But do remember, all you folks out there that do use medical pot for pain (like many people without insurance or trying to reduce opiate use do), please remember it will LOWER YOUR BLOOD PRESSURE AND RAISE YOUR PULSE. Back in the day, this reaction was called "Paranoia". Now we know better. So, take care with it. Hope this experience helps someone out there. It sure saved me.
Thumper2, April 27, 2018 8:56am EST
MrDon55, I've had no experience with chemo coupled with AFib but can ask if you have the option of getting a second opinion on your combination of ills? Would someplace like the Cleveland Clinic have experts on this combination? It sounds like you're doing a great job on self-treating, but you shouldn't have to be your own doctor, so much of the time! Thank you for telling your "story." One other question -- have you been tested for sleep apnea? A large percentage of folks with AFib also have sleep apnea and benefit from dealing with it by using a CPAP.
Keep us posted!
Larkspur, April 27, 2018 3:58pm EST
"$45 got me a sealed packet with a Nevada tax stamp on it. Back at the hotel, I smoked an amount about the size of two BB's. That's ALL. In 15 minutes I was 127/62, pulse 81. Normal. Wow. Saved my neck."
Do you know what they prescribed (Indica, Sativa?). I also use medical cannabis and find that it is generally helpful though I have not had an Afib episode since I got my card so don't know how the blend I have would affect me. Glad it was so helpful for you.