Information, not ablation

Ablation: A relatively new procedure that scars or destroys tissue in the heart with the aim of getting the heart to beat normally.

The doctor I consulted last week specializes in ablations. My cardiologist referred me to him because the heart medication wasn’t working to control my atrial fibrillation.

I wasn’t there that day because I wanted an ablation. I wanted more information about how I could fix my atrial fibrillation (A-fib) naturally, but I knew that I wouldn’t get that information from him. I had gotten that information myself and was hoping that taking cell ready liquid magnesium and other mineral supplements, listening to high frequency music, and correcting my breathing patterns over the past couple of months had put my heart in sinus rhythm.

The TV on the wall in the waiting room broadcast eerie warnings about all the possible things that can go wrong with your heart, no doubt a deliberate strategy to scare the bejeezus out of us sheeples so that ablation looks like the only solution.

After my name was called and I shuffled into the consultation room, the nurse ran an electrocardiogram and asked a few questions about my medication history. I told her the side effects to my heart medication were intolerable and I wanted off! She agreed that the drug should be dropped. I noticed a cardboard sign on the counter opposite us illustrating what dead arteries look like. I excused myself, got up off my chair and walked over to turn the picture to the wall. “Gee, said the nurse, “I had thought about removing it because we don’t deal with artery disease here.” (I couldn’t help noticing that the only pamphlet in the room was a glossy brochure on why you need an ablation. Continue to ramp up the fear, why don’t you?)

To my immense relief, the ECG indicated that I was in normal heart rhythm. I haven’t had a normal rhythm detected in a doctor’s office since one was last heard in December. I may still have A-fib, it’s just that it now it appears that I no longer have persistent A-fib. I’ll take that.

Now, if I was expecting this doctor to talk to me about natural means of eliminating my A-fib I would be incredibly naive and misinformed about what a heart rhythm specialist in Florida actually does and how much he earns doing it. The top heart rhythm specialists (electrophysiologists) can make more than $600,000 a year, way more than even what cardiologists earn here. I’m guessing the doctor I was about to see earns well over a gazillion dollars per year because there are lots of us old folk in Florida who have arrythmias. We’re easy pickin’s.

Getting a second opinion from an MD in Florida strikes me as a waste of time. I had done my some of my ablation homework by searching for second opinions from YouTube cardiologists about what atrial fibrillation is and why ablation should be avoided. (Don’t let your doctor tell you otherwise: YouTube is a great source for medical second opinions.) What I learned from YouTube about ablation is this:

The operation is successful in about 30-60% of cases. Many people have to keep having them done and of course, it is a surgical procedure that carries its own risks. You should only consider ablation if you feel that your quality of life is impaired, for example, maybe you’re an athlete who doesn’t like getting winded or maybe you’re a sedentary type but having trouble doing even small amounts of physical activity. It’s not for people like me who are able to live with it. Better yet, rather than just living with it or going for the surgical option, why not first investigate the miracle of liquid magnesium? As ablation is a relatively new procedure, not much is known about what can happen to your heart down the road because of the procedure. You still need to take an anticoagulant even if your ablation is successful. Just because you have no more heart arrhythmia does not mean that your risk of stroke has diminished. Strokes are fellow travellers with A-fib but A-fib does not cause strokes, as my favorite YouTube cardiologist explained. You need an anticoagulant to mitigate against strokes, not an ablation.

I also learned from YouTube that A-fib can be minimized and even eliminated using natural means. The benefits of cell ready liquid magnesium are touted,** the desirability of losing weight if you are overweight, fixing any sleep apnea, cutting back on coffee and alcohol, destressing your life, etc. And, most critically, you don’t need an ablation if A-fib doesn’t bother you.

The doctor I was about to see makes his living by telling you that A-fib is a problem, and he can do something about it. Here we should all pause for a moment: Remember the enthusiasm for lobotomies back in the 1940s and 1950s where connections were severed in the prefrontal cortex of the brain in an effort to control mental illness? How well did that experiment turn out?

There was a quick knock on the door and the high earning specialist entered the room. We shook hands, exchange some pleasantries, and got down to business. I had about fifteen minutes to find a drugless way forward.

Right away he said that I could drop the heart drug I’m currently on. (Strange that even though the ECG reading was normal for the first time in months the doctor didn’t claim that the heart drug was now suddenly working. If there was another explanation for why I was in sinus rhythm, he wasn’t curious to know.) I briefly started talking about the magnesium effect, but he wasn’t listening. He had whipped out a pen and notepad and began drawing an electrical storm of misfiring atria while enthusiastically writing down and circling the names of the drug possibilities I could take to control the A-fib. No talk of ablation but also no talk of natural means. He was fixated on the drugs of which there were about seven. He mentioned a “pill in a pocket”, something I could take as needed when my A-fib kicked up. “Okay, I’ll take that one,” I said, not that I was planning on using it. He promised to phone my prescription in to the pharmacy. End of appointment.

On my way out the door he asked if he could give me more information on ablation, evidently hoping that I might reconsider. I said I’d be willing to consider having the procedure done if I felt that my quality of life was becoming impeded. “What are the chances that the procedure would actually be successful in my case?” I asked playfully. (I knew the answer.) Funny, but I don’t remember his answer. I think he laughed, but I’m not sure.

If you’ve read all the way through to this point, you may be wondering what on earth this has to do with my usual theme of schizophrenia. My point is this: How would someone half my age with a diagnosed mental health problem be able to do the amount of homework that is needed to be an effective self-advocate, let alone make himself understood in a fifteen minute med check?

Fifteen minute med checks are a danger ground.

*The usual disclaimer: I am not a doctor and what I am writing should not be construed as medical advice. I specialize in opinions only. Do your homework. Form your own opinions.*

**See Dr. Carolyn Dean, MD, ND