Friday 30 October 2009

Being trying a new technique to stop an arrhythmia.

Basically pushing down on the diaphragm really hard, like being pregnant and pushing the baby out and pressing on the vagus nerve. Fill your lungs to help with the pressure then tension the stomach muscles hard, pressing down and hold. I have been doing it for a count of ten, perhaps couple of times immediately the arrhythmia is detected.

So in bed this morning 5.30 I was woken by AF and again this evening after loading the trailer with kayaks after the pool session. Both times the AF cleared up. I also tried this morning when AF started on getting up, it did not work. But 2 out 3 today is pretty good. I suspect it postpones rather than means the AF goes away but hey that's still good in my book.

Saturday 24 October 2009

This week has been a complete contrast. Started off being tired, very late to bed and significant deterioration in mood. So 29 hours of AF by Tuesday evening and I think a few more before almost lunch time Wednesday and the start of the longest AF for a while - 2 days ie 46 hours. I took 150mg of flecainide early on with no effect. Not sure when I tried again.

Went jogging 3k on Wed before the AF and Thursday while in AF. Then in the evening to the Alford pool kayak session. The AF cleared Friday morning after taking another dose of 150mg flec in the morning. Iin the afternoon I paddled the Don from Kemnay to Inverurie 5 miles or so in high flows and cycled 10k back. But rather than more arrhythmia with the exercise Friday saw the start of the longest session of NSR for at least six weeks. By Sat evening 34 hours when the next AF started. I have not exceeded 24 hours of NSR for a long time. Cycled 12k on Sat am.

Does it suggest that there is a cycle - the body needs to go through a cycle and corrects itself in some way. This certainly something I have felt before and others have suggested.

By Sunday evening I had had about 93 hours of AF for the week. Worst for ages.
Last week gave the lowest level of arrhythmias for ages - about 37 hours for the week. Had quite a lot of episodes - at least 1 every day and at least 11 in all. Not sure why the total so low though less exercise recently so less tired, emotional changes also. I tool 150 mg of flecainide as a "pill in pocket" fairly early on in each episode which appears to have helped clear them up.

Arrhythmia triggers were interesting. Started arrhythmias:
immediately on lying down in bed
while asleep, it woke me up
a few moments after waking
around eating.

Thats all pretty vagal.

Sunday 4 October 2009

Salt

An interesting item on one of the A-F-A mailing list pointing out that during an arrhythmia the heart releases a chemical which makes you wee more. OK but pointing out that it is to excrete salt. Hence for example needing to get up more for the toilet at night.

Now for me during exercise I have found replacing salt to be very important to reduce arrhythmias. I use lo cal salt to give a mix of calcium and potassium. So maintaining salt balance appears to be important.

Yet apparently the heart needs to excrete salt. Intriguing. Both may be true but if so how and why?

Paddle on the Findhorn

Had a good trip on the middle Findhorn. Lots of water, sunshine & good company with Juta, Vicky, Kirsty and Ricky. Thanks folks.

Arrhythmia started during night & took 3 flec and cleared within 3 hours. Not too bad but with a good sleep - about 9 hours - it was away again in the morning, I think as I woke. I believe a good sleep can leave the vagal system dominant and bring on the arrhythmia. I thought it cleared on the way to paddling so did not take any flec. Only it was a strong 140 as I got changed and persisted all the way on the river. I normally feel I know when it is settled but definately not this time. An arrhythmia is usually not too much of a problem while paddling. There are short bursts of effort followed by relxation so my body can rebuild. Sometimes I do need to take extra rest. The biggest effort was the walk back to the road where I hit 200 plus; not good.

Coffee and cake on the way home. Good for me, took 3 flex about 6.30 and back to nsr by 8pm, after a glass of wine (or 2). OK that is not good for the arrhythmia but it is good for me.

About 51 hours of arrhythmia this week counting today as 15 which is brilliant.

Findhorn was running about 0.6 or so on the guage, about medium. A good level as much higher I think would just wash out. As it was "dragons teeth" was just a wash through. Much higher and it would be an interesting run all the way from above Tomatin on the A9

Saturday 3 October 2009

Being more than a bit lethargic just now. No paddling last night and not much done today. However opened a face book account, how does it find your contacts?
Also put photos on flickr.


A fib has been fairly quiet. Started at 4am and I took 3 flec. It cleared after about 4 hours but I couldn't sleep for a good hour or so. There are 2 techniques that seem to work. Either an all body gently work out / stretch or simple tensioning muscles throughout my body for about 25 seconds each and then relaxing seems to work. In either case followed by something to fill the brain like counting sheep. Only I use reciting poetry or song. Usually the same ones and repeatedly, you don't want anything to think about. I think using the same ones acts as a trigger or que for the brain to shut down.
Total afib for the week now about 35 hours and its 136 hours of the week. Thats pretty good.

Friday 2 October 2009

Slept soundly last night which contributed to an arrhythmia starting at 4am when I got up for the toilet. Took 3 flecainide but that did not help. It finally cleared once I was up and about, and feeling pretty good after a good nights sleep. If I am tired I can sometimes ignore the arrhythmia and sleep through it.

Been a hectic few days. Up at 5am on Tuesday to go down to a conference on direct payments for disabled people to manage their own support. Why is it that seminars supposedly designed for a consultation are so awful? It is not rocket science to do it well but this was particularly bad. The only saving grace was a short chat with a West Lothian Social Worker which was very worthwhile.

Anyway did not get to bed early the night before, bed late that night since Ann & I went to a meeting discussing wind farms with friends. After being sociable I then walked to dog, so well after midnight.

Wednesday was Carriage Driving for the Disabled. I help by cycling with the carriage in case needed. However it was the 40th anniversary of riding for disabled so they had arranged for all the branches to have a timed lesson to have the world's largest riding lesson. So there was no real cycling but still jobs to be done.
In the afternoon Ann persuaded me to look at a couple of young dogs, sisters, that had been taken to the vet to be put down. The Vet was not keen to do that and was trying to re home them. Ann would love a second dog. Against my better judgement I agreed we might take one for two weeks "to help out". Anyway its a lab cross bitch, probably a bit of bull terrier in it. Pleasant enough dog but of course it would not settle at night. Of course it was me settling it down for the night and it was 2 am before it stopped barking.. Our lab Holly was accepting enough but was certainly making sure it knew it was bottom of the pile.

Just to keep Ann happy it killed one of our ducks. That will take some management to ensure it does not do that again. Perhaps it has just settled its future and will be re homed but not here. We will see.

So a good nights sleep last night is a change for this week.

Thursday 28 May 2009

I keep meaning to start this blog again. Well I have just done an email for another purpose which sort of fills the bill for where I am. So here is my slightly adapted response to a young fella who was asking about exercise and AF. He's in a much harder position than I, being young and loving the adrenaline of hard exercise.

Being 63 I am at a different point in life but I will try to summarise my approach to exercise and AF. Sorry this is very long but there may be something in it for you.

I had been reasonably active and fit till about 1990 when we moved to Aberdeenshire. About 10 years ago I started to get a bit fitter, jogging mainly and some cycling. I was planning for being fitter and doing things that I had always wanted to do when the children grew up, the current ones are my second "brood".

Our youngest is now 17 and I had reckoned that by this time I would be doing well. However the AF got in the way. I couldn't jog without setting it off so developed my cycling. I used to cycle a lot when young but had got into kayaking, skiing and climbing. However despite many hundreds of AF events over the years, some lasting a week or so I have always self converted. Initially they were short and only in the last year or so have they got longer and now I just expect them to self convert sometime soon.

Psychologically I also found AF very depressing. I had planned to do so much at this time of my life and all the info I found said this embuggerance was likely to kill me and certainly stop me doing all the things I wanted. Things that all through life I had promised myself.

I slowly found info that encouraged exercise, which fitted in with my view of life. So I did more cycling since I could manage the pulse rate better than jogging.

One significant day about 6 years ago was over Cairn O Mount near Edzell which is a fabulous run perhaps 40 miles and 3.5-4000 feet of climbing. It was raining, a bit wild and it is fairly isolated. I had an AF episode and carried on slowly up the climb. I felt significantly at risk but I could always go down. It eventually cleared. So I reckoned in the future I could always go on but should avoid the more risky situations. So no remote mountaineering, careful where cycling, probably no significant kayaking - could be at greater risk if stuck or having a big swim. It was in fact a turning point - coming through a bad day meant I could do it again but I was still very scared about the threat of AF.

I had completely written of the max effort training, it brought on AF. I was working towards longer steady cycling. I found as I got fitter I felt better. I could do some of what I wanted. For my 60th birthday I went cycling in the Alps with long steady 75% max heart rate efforts which I really enjoyed and got me quite fit. Been to the Alps a couple of times since. They have been great trips but I have found I get tired very easily - I do not recover so well. Its partly not being able to get the training in before going. But this is part of the recovery issue.

The recovery issue is partly age, life style but also I think the AF.

I do weights but again I have found I am forced to do pushy but not max work outs. Sets of 5 work better than 10 because the strength basis takes less recovery. But even the 5 are not max. But now I am more into maintenance rather than big gains.

Meanwhile my AF has become much more frequent. At the same time I have realised I can do much of what I want despite the AF, just at a lower level. So now I train a little with weights, am back jogging (that was very emotional) cycling, kayaking, some rock climbing and plan some decent mountain walking. The idea of a few biggish rock climbs is slowly developing its appeal.

My AF is vagal linked but also very much sympathetic which is why I have tended to rule out exercise as the cause, exercise for me can stop AF, taking a few weeks off does not clear it up. However as I have read more and more I am forced to acknowledge that longer hard exercise for me stimulates and may contribute to AF. A couple of my earlier posts give some references for published papers and if you would like them I can post again.

So for now I have limited my training time to 45 minutes if I am working hard. This year I started doing a very simple 6x30 second efforts cycling with long (4.5mins) rest. They are reasonably flat out but very rarely trigger AF. I think this may be because in effect the effort is significantly anaerobic because it is so short, heart rate lags well behind. I can do them in AF. I am back kayaking a lot as I am planning to go to Austria with one of my boys this summer so the cycling has taken a back seat. White water kayaking is pretty lazy. It requires short efforts rather than long ones so seems to work OK despite being on the river for several hours.

As soon as I increase the cycling effort to 1 minute I find I need to be steadier in my efforts - especially if I am in arrhythmia. If I could get out more often I would try some 5 minute hill repeats - only 3 or 4 in a session but for me they would be more rewarding. I expect them to be fine and plan them later in the year. However they are still likely to be moderated at low 80s% max effort and I would now not expect to reach 85-95% max heart rate as I used to. Will report back on how they go.

If I go out for longer trips then it is at a much lower effort - so far below 65% max even when climbing. It is early days but for me it is working.

Of course I am an old git so some of what I do comes from that. I am no longer so bothered about high intensity work outs. But if I could I am sure I would!! For me it is absolutely part of life to get out, so being out is more important than intensity. So it is absolutely wonderful to be able to do these things when I really thought I would never do them again. I now have some fantastic memories that inspire me, so I know I can repeat and do more.

Having felt I would be unlikely to have another ten years and not be able to do very much of what I wanted in whatever time I had I now look forward. The next ten years will be good - for what I will be able to do and the family I will watch grow. I'll see about the following ten after that!

I met a gent takling some Monros 20 years ago who finished his sentences about what he was going to do with "if I am spared". I used to chuckle at his phrase. I now feel he was a man of insight. AF has taught me to respect and value that phrase in a whole new way.

I was also chatting about you to my 17 year old son Stu who is very much into getting fit, does a lot of Crossfit stuff, olympic lifting etc.. He used to play rugby but now into judo. He very much shared my sympathies for your position and the loss you must feel. Decathlon is one of the best all round tests of fitness - speaks volumes about you on its own.

Your value does not just lie in your fitness but in you in all sorts of ways.

There is a site for cardiac athletes at:
http://www.cardiacathletes.org.uk/forums/index.php
There are a few folk with arrhythmia problems on the forum so that might be a useful resource, as well as some others with stunning problems and still working out.