G:TB Special Correspondent: Chronicles of an Aging Gheorghie

When we left @fairbankobx last, he was hearing the world in entirely new ways. Alas, there are more body parts than just ears that we have to pay attention to as we grow older.

The doctor entered the exam room carrying a computer printout and a quizzical look.

“You’re my surprise of the day,” he said.

Not what you want to hear.

My new primary care doc scheduled a physical, so he could have a baseline from which to take care of me. Family history, blood work and an electrocardiogram, to listen to my heart. Results from the blood work aren’t available for a couple days. EKG results are available within minutes. Hence, the doctor’s puzzled take.

It’s called an atrial flutter with a variable AV block. It means my heart is beating arrhythmically, a little like a Thelonious Monk piano riff or Lindsey Graham dance party.

The flutter itself isn’t necessarily a problem, but it increases the risk of heart attack and stroke. Because the heart’s electrical impulses are a mite off, clots may occur within the heart. Should one break loose, it can travel and cause all sorts of non-Shaka Smart havoc.

My doc showed me the EKG printout and went through the list of symptoms. Ever had heart issues? Palpitations? Chest pains? Dizziness? Shortness of breath? Ever fainted? Nope. Are you sure? Yup. Really? Yup.

I’m 57, but I try to keep myself in moderately decent shape. I run a little, work out at the Y. I have the attendant aches and pains and twinges, but nothing out of the ordinary or chronic. I sure as hell didn’t associate them with heart issues. Maybe I should have, since both Mom and Dad had heart problems. Mom had two mild heart attacks several years apart in her 60s, Dad had bypass surgery after a catheterization revealed a significant blockage in a coronary artery.

Anyway, my doc phoned the cardio specialists down the road and passed along the EKG results. They wanted to see me immediately. Terrific. I didn’t know if it was because I was a ticking cardio time bomb, or because I was some sort of research test case – a guy who oughta look and feel a whole lot worse than he does.

When I arrived, I saw the cardio specialist’s assistant, a chatty, amiable fellow who asked all the same questions as my primary care doc. He told me about the increased risk of stroke with atrial flutter and prescribed a blood thinner to reduce the risk. He went over the risks of taking blood thinners – namely, bleeding out.

Word is that Arnold had fun. Lots of fun.

“Don’t get into a car accident or a knife fight,” he advised. Check. Bicycles and slap fights only.

Anyway, he put me on Xarelto, a once-daily pill about the size of a bacon bit, but with a whole hog pricetag – about $400 per month. Fortunately, he gave me a few weeks’ worth of free samples. I’ve taken the stuff for a week and haven’t had nearly as much fun as Arnie, Kevin Nealon and Brian Vickers on the drug’s TV commercials.

He also scheduled me to see the cardio specialist 11 days out. I asked him if, amid all the potentially dire consequences of my arrhythmic heart, should I be encouraged that neither he nor my primary care doc took one look at the EKG results, immediately strapped me to a gurney, shoved a bunch of tubes inside me, and called a priest? That my situation was so perilous that I wasn’t seeing the specialist for 11 days? In so many words, he said, yeah. However, that’s not to say that something couldn’t manifest itself on the ride home. Great. Thanks for the pep talk.

Eleven days later, I saw the heart guru. He said that most people will experience some sort of atrial flutter or fibrillation, if they live long enough. Some folks contract it at age 40, some at 80. Sometimes it corrects itself, other times not. He didn’t know what caused mine, only that it occurred within the past two years, between my last EKG at my former doc’s and now. I attribute it to our recent move to the Outer Banks, where my heart thinks it’s on permanent vacation and has gotten lazy and undisciplined.

The heart guru scheduled a transesophogeal cardiogram at the end of the month. They’ll snake a tube with sensors attached down my throat so that they may get a clearer picture of my heart. They’re looking for clots and for abnormalities within the chambers. If they find no clots, they’ll attempt to electrically shock the heart back into regular rhythm. That procedure works about 50 percent of the time, the doc said. He said that there is virtually no risk in shocking the heart the way they do it, odd as that sounds. No paddles and orderlies calling “Clear!” That’s TV and movie emergency stuff. This is much tamer. I plan to inquire about bundling the shock with my power bill for a discount. 

If they find a clot, they won’t attempt a shock, for fear of dislodging it. If a clot is dislodged, all bets are off.

If they find a clot, or if the shock procedure doesn’t work, the next possible step is something called

cardiac ablation. Catheter ablation involves inserting a tube into an artery through the leg or neck and toward the heart. The doc uses heat, cold or radio energy to treat the area triggering the irregular beat. If it comes to that, I’m requesting WWOZ in New Orleans, or maybe B.B. King’s Bluesville on Sirius XM.

That has to cure arrhythmia, right? Or at least prompt everyone to boogie.

Laissez les bon temps roulez.