WOMEN AGES 50+ FOR APRIL 2024

I'm in what's called permanent a-fib. It's kind of funny to watch medical folks who don't read my chart well enough to know I've got it. When they listen to my heart with a stethoscope, their eyes widen and they start to freak out.

Basically, the top part of my heart is just flapping in the breeze in the way it beats, while the bottom half works just fine. Without blood thinners, bluntly, there is no way for any of the possible fixes to a-fib to work, whether surgical or otherwise. Those choices are, in order of seriousness:

• cardioversion or electrical shock, which doesn't seem to work for permanent a-fib, it's a temporary fix only;
• cardiac ablation, which is electrical shock applied to only a small part of your heart, the same place where the Watchman would be put;
• cardiac maze procedure, which is basically scars laid down on the heart tissue which correct the electrical signals and prevent them from getting all wonky again; or
• a pacemaker.

At this point, they're not even contemplating doing any of these things to correct the a-fib and get my heart back to normal rhythm. The most recent tests all showed that my heart is in extremely good shape, very healthy, undamaged and clot-free. It's electric signals are just out of whack in the top part of the heart.

The Watchman, if I let them install it, would be inserted into one area of the heart and stay there permanently. It is basically a little screen that keeps clots from from forming there. That one specific area (called the left atrial appendage) is kind of a divot in the heart, and if you form a clot, that's where it's most likely to be formed. If a clot is formed and if it breaks loose, then it may cause a stroke. That's an awful lot of "ifs" to me.

Most people who have a-fib are on blood thinners to prevent clots entirely, but those aren't safe for me. However, they want me to take blood thinners before and after putting the Watchman in. That's why I'm saying "no."

I'm saying no because the beta blocker they're giving me keeps my blood pressure in the perfect range (around 108/65 to 110/70) and I'm doing almost everything they want me to do to prevent clots and/or strokes, except avoiding caffeine. And bluntly, there's a lot of evidence out there that caffeine may actually prevent stroke.

I'm reasonably comfortable with saying no right now as well because more than one study, including this one from the Mayo Clinic shows there is little evidence of elevated stroke risk within the first 25 years post-diagnosis. In all reality, until after the age of 75, a-fib doesn't seem to correlate with increased mortality at all.

I'm not saying it doesn't worry me, don't get me wrong. I'd prefer my heart was working correctly. But I'm doing everything I can at the moment to prevent problems. If I can (fingers crossed) get the rectal bleeding from the ulcers in my colon to stop, then I will sit down with the cardiologists and decide whether the Watchman makes sense. As of yesterday, the bleeding has very definitely NOT stopped, it's just less frequent and of shorter duration. The first infusion of Skyrizi is Friday, and it needs time to see if it's going to work on the Crohn's disease and let my colon ulcers finally heal.

Hopefully in the meantime I don't fall over dead from a stroke. 😀🤷🏻‍♀️👀😁 I never, ever make this kind of major decision without weighing every possible option, and doing the research.