They’re on the prowl again. They came last night and gave me a prod. Not a big one, just a nudge to let me know I’m not forgotten. How could I be? I have two visits in little over a week.
For about 10 weeks from mid-November (23 weeks on from the ablation) things were quiet. Then in mid-January (week 32) I decide (with the cardiologist’s blessing) to stop taking bisoprolol (beta-blocker). The Gods of Arrhythmia are not happy. On January 25th a full-blown arrhythmia, with tachycardia and a side order of ectopics. It lasts about 8 hours.
I make an offering – I reduce the dose by half and promise to stay on the lower dose until I see the cardiologist again in 4 months time. I’d like to stop because I don’t like the side effects. I could get other pills to counter the side-effects but I fear getting drawn into a cycle of dependency – and I’m not talking about a shopping bike.
I update the graph. If you’ve not seen it before, the vertical axis shows the duration of each episode, the horizontal axis shows time. I’m defining arrhythmia as irregular heart beats, ectopic (missing) heart beats or tachycardia (elevated heart rate over 100bpm which lasts for a couple of hours) – either singly or in combination. I’m not including palpitations – I often wake in the night with a rapid heart beat – so do lots of others; it’s not uncommon in perfectly healthy people.
From week 18 I start taking the pill-in-the-pocket (flecainide) each time there’s an episode and the duration comes down, in most cases, to a few hours. So I think they work. But it can take a day for the consequences – nausea, lethargy, breathlessness – to go away.
It’s now been 42 weeks since the ablation. Is there another pattern emerging? I really need more data points – but I don’t want more data points. I can’t stop being curious; I assume that if I can identify a cause, I can stop the occurrence. But it probably doesn’t work like that. The human body is far more complex.
So too is age. I have begun to think lately that cancer – or rather the consequences of treatment – has aged me by at least 5 years. And when my friend Neil comes round for a catch-up I realise, after the usual pleasantries, that we’re talking about people who are either ill or no longer with us. When I was young we talked about cars. Now I’m older we talk about scars.
In a few months time – statistically speaking – my risk of stoke is going to increase. The cardiologist uses a scoring system (CHAD2) for assessing the risk of stroke in people with arrhythmia. The system assigns a numerical value to things like family history, life style, current illness and age. At present my CHAD2 score is 0. Which is good. I am at little or no risk of stroke. To maintain this state of affairs he prescribes low dose aspirin as an anti-coagulant. But he tells me that this will all change when I’m 65. It sounds like it’s all going to kick off on my birthday. What he means is that I will fall into the next age group that has a higher numerical value. So my CHAD2 score will increase and by implication – my risk of stroke.
There’s a TV news item about a man who’s had a very severe stroke. He’s been bedridden for about 8 months. Now he’s training to become an Olympic torch-bearer. I see him push himself through the pain barrier in order to be able to walk. So I get on my exercise bike and do 30 minutes instead of the usual 20. It hurts – and I’m in much better shape than him – if he can do it…
I give myself a high-5 as I stagger of the machine. I look in the mirror; I’m 64¾ and as fit as a fiddle used for crowd control by Nero’s bodyguards as he fled the burning city.
So much of this is about mental strength rather than physical strength. The brain is the most selfish organ in the body. It always puts itself first. Research into exercise tolerance shows that the brain will want to give up long before the body actually needs to, simply to save itself. Perhaps that’s why some people appear to age more quickly than others. They listen to their brain and not their body. Which is understandable – it can be very persuasive. Think payment protection insurance.