AFib

When the CardioPulmonary Specialist formed the words 'Atrial Fibrillation', my initial reaction was to laugh.

This response seemed to throw him. Had he been expecting shock, horror, grief, hysteria?It sounded so grownup, so much the preserve of the aged, how could it possibly be something remotely touching my life?

I realized how immature I must have seemed to him, laughing peremptorily at what I suspected must be a rather serious diagnosis.

"You're laughing. It's nothing to take lightly." He seemed confused, taken aback by my unexpected and wholly inappropriate reaction.

"I'm sorry." My face feigned what I hoped was a serious countenance. "It's just so weird. Isn't that an old people condition?"

"It does tend to occur with greater frequency among the senior population," he replied, no doubt suspecting I was less than intelligent.

As "how could this possibly relate to me?" screamed in my left ear, I got what I hoped was hold of myself and attempted a serious recalibration of my countenance.

"There's no way," I attempted to assure him. "My diet is intentionally healthier than that of anyone I know, I've spent years in gyms building up my aerobic and strength capacity and I'm not old."

"Who told you that?" asked my specialist, looking for all the world as if he were actually expecting a serious answer.

"No one told me," came my answer. "It's just a fact. I know I'm in better shape and healthier than most people my age. People used to call me a 'gym rat'. There were even a few years when I belonged to three gyms at the same time just to get all the different types of training and activities I wanted."

"That's a new one...'gym rat'," he said, mostly to himself.

Was he mocking me?

I looked at him pensively, suddenly realizing we were actually being serious now.

"Seriously," I ventured appropriately. "I've spent decades doing all the healthy things. I've taken care of my heart. I've taken care of all my bits and pieces. Very carefully and intentionally. "

"Then you should thank yourself that your heart's not in worse shape. And we've caught it fairly early."

I found it hard to swallow that 'we' had caught anything. There had to be a mistake. Mistakes happened in the medical world. In my own life, my x-rays had once accidentally been switched with someone else's, leaving me and my doctor temporarily befuddled that I seemed to have a fractured elbow, and not the ankle I knew was only sprained. Worse, there was the time the envelope with my MRI brain scan and results turned up at that specialist's office empty.

These things happened.

Attempting to inject levity into the exchange, I said, "Is this a second opinion? How many technicians does it take to change an x-ray?"

He didn't seem to understand my intent to downplay his diagnostic pronouncements.

My heart started beating in a whole new rhythm, but I didn't want to settle into this new information.

Looking up at me from under his heavy eyebrows, he adopted a somewhat reassuring tone.

"It's early enough to be treated with a drug regimen. That will lessen the possibility of stroke."

"Stroke?" I couldn't believe what my ears were assuring me he'd said.

As the doctor's words seemed to dangle pointedly between the two of us, I knew I had to reassess and realign my responses.

The next thing I said struck both of us as conciliatory.

"What's AFib?" I finally asked, realizing it was just a term I'd heard or read. I didn't actually know what it entailed, something I hated to admit.

He seemed bemused by my query, as if I had asked about something I should already have known. When my silence had settled snugly over the room, he appeared to recognize my actual ignorance.

"Atrial Fibrillation," he finally began "is a type of arrhythmia, or abnormal heartbeat that’s caused by very high and irregular beats from the heart’s upper chambers.”

This did not sound good.

I ventured a followup question.

"How serious is it vis-a-vis longevity?"

He appeared to grasp my sudden realization of import.

I was alarmed when he came back with, “It can be serious. The blood flowing into the heart usually gets pumped out with every beat but, with AFib, blood can pool inside the heart and form a blood clot…”

Oh shit.

He continued, “The likelihood of strokes in people with AFib is five times higher than for a non-sufferer, and the type of stroke is a more serious kind because it causes more damage to the brain.”

I felt deflated. And scared. “Now what?”

“Well, you’ll need an individual stroke risk assessment for starters,” he explained.

“How do I get one of those?” The panic was beginning to set in.

“I’ll give you a referral to the CardioPulmonary Clinic.”

Seriouser and seriouser.

I was determined to remain superfluously brave and nonchalant. Realizing I was suddenly on my feet, I sat back down. Almost sheepishly (I think I cocked my head to the right), I nearly whined, “Well, this is shitty. Are there things I have to do? Change my diet or start a specific exercise program?”

“Whatever you can do to ensure you’re in the best of health possible is what you can do. Diet and exercise are important. Drink lots of water…”

(No problem. I’d been told a year earlier that I drank too much water and it was causing my bladder incontinence.)

“Avoid stress,” he warned, almost casually.

At this I totally lost it. “I spend my life trying to avoid stress, and have the medicine to prove it.” Pause, recoup. “So, am I totally screwed?”

I think I saw him suppress a smug grin. “There’s no predicting who's at most risk, or when it can happen, so just live around it, and take care of yourself.”

“That’s your professional opinion?” I wanted to ask, but restrained myself.

I must have seemed rightfully terrified, because he said, “All you can do is follow the precautions and…”

“…hope for the best?” I assumed I’d finished his thought.

“Actually, yes that helps. It’ll keep you vigilant and conscientious about your lifestyle. And that’s the first step.”

“What about the Cardio referral?”

“OK, that’s the first step,” he grinned. Finally.

“I’m sure Google covers all the bad stuff. And the warning signs. And how shitty my life is going to be now.”

“Yes, exactly.” He smiled broadly. “Just how very shitty your life will be now.”

I laughed.

And I laughed all the way to the blood bank.