Atrial Fibrillation and Pain

I did think of calling this “Panic and Pain”, but I’m not so panicked by Atrial Fibrillation since I experienced it in hospital and the Doctors and Nurses were so blasé about it – apparently it’s very common and around 40% get it post-op. However I didn’t expect it to surface again when I was at home.

Before I get onto that though, let me talk about pain first.

I remember, before I left hospital, that there was a clear message about only taking the heavy painkillers if I needed them. That seemed strange to me considering the message about pain you receive before going into hospital was to take the pain killers as soon as you started to feel uncomfortable, something I did a number of times with my self-service medication, but apparently not enough. I remember the machine I used to self medicate being taken away from me early because I wasn’t using it enough, and then I went onto a normal regime of drugs.

I must admit that I was surprised by that, and surprised by the fact that the pain was much less then I expected. I think this is perhaps one of the reasons I was let out so early and sent home, I was coping with the pain as well as recovering well.

Getting prepared for going home I was told that I should take the heavy duty painkillers when I needed them, and the maximum regime was four times a day if it was really bad. Also, the painkillers were responsible for the constipation that almost kept me in hospital another day or two – no discharge, no discharge. Sorry, I couldn’t resist that one.

I quickly turned to one a night, using it to get me through a night’s sleep, propped up in bed and not able to turn over. It seemed that during the day the paracetamol were keeping me in check enough, so I’ve stuck with that regime.

That thought is changing at the moment though as I experience a sharp increase in muscle pain across my back, shoulders and neck. The hot searing pain can come on gradually (knowing it’s coming makes it much worse), builds for a couple of minutes and then holds at that level. After a few minutes the pain will slowly subside and fade into nothing.

I must admit that I’ve become used to this, it’s as bad as the pain would get before I started visiting a chiropractor, although before it would happen once every few months. Here, post operation, it seems to be happening multiple times a day and yesterday was the worst. I think I counted four or five times with two right after each other.

My wife can only look on as I try not to show too much pain to her, but even she said that it was enough and I really should take a painkiller, in fact she’s keen on me going to two a day, one morning and one at night. I’m not so convinced however, and I’m putting some of the worst days down to healing pain which will soon clear. Anyway, the pain I’ve been experiencing isn’t all the time, doesn’t always come in so many bouts per day, and each one does clear up after a few minutes.

So that was the pain, and one of the worst days for it happened at the same time my Atrial Fibrillation (AF) returned.

I woke up on Monday morning to a fluttering feeling inside my throat and chest and I knew instantly I was back to having an irregular heart rate. I lay in bed trying to breathe slowly and control it but to no avail, instead it started beating heavier and with the clicking sound it kept me awake because of the noise and the feeling – it really is hard not to be aware of your heart clicking!

I waited until my wife woke up as well and then we both got out of bed. An hour later we called the surgery and arranged for a doctor’s call back which we received some time later – our surgery performs daily phone calls to patients to try and keep turnaround and waiting times down. Here though, I’m not so sure it worked.

The doctor took my pulse over the phone. It’s not very easy to read out your heart rate aloud when you’re also trying to feel it beating. I ended up tapping it out on my wife’s hand who then read it out over the phone. It turns out it was around the hundred and twenty bpm rate, similar to when I had AF in hospital. The doctor said that I should phone the consultant and see what they said.

I called the Cardiac Liaison Nurse who promised that they would get the Registrar, who was currently in ICU, to call me back before lunchtime. So I lay down and tried to rest. Well the truth is that I was getting very tired from the elevated heart rate and could easily settle down to sleep. I was dozing when my wife called them back to chase during lunch, under an hour later we received a call back telling us something we had already thought of doing, increasing the dose of drug on the heart rate medication I had.

Now that thought doesn’t seem as irresponsible as you might think, the medication instructions have clear maximum dosages on them, as well as recommended, and my dose was below both. Still, we waited all that time for the official word, and that was to double the dose. We did, and later that evening my heart rate began to come under control again.

AF is a scary thing, especially when you can feel your heart rate so easily with a mechanical valve. Luckily my AF wasn’t putting me in any danger, just making me sweat and sleepy, but for others it can increase drastically. While I had it in hospital I was up to about a hundred and twenty four bpm but one nurse said that this was nothing and that they’d dealt with patients with their bpm hitting over two hundred, and that was a point to worry about. My rate was easily manageable.

Of course that doesn’t stop you worrying, and feeling your heart beating in your neck and chest, missing beats and doubling or tripling up on others is rather disconcerting.

The good news is that today, Tuesday, it is much more under control, even if I am very tired today.

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