I'm not asking for med advice here, or at least I don't think I am.
What I want to know from anybody out there is this:
Can I still pursue and achieve my dream of becoming a doctor with Uncontrolled Atrial Fibrillation?
My first love is OBGyn. Read below:
I just spent the last 4 more days in the hospital due to fluid on my lungs and uncontrolled atrial fib. I was first diagnosed on 5/19/03 and they tried to electrocardiovert me which didn't work so they tried to chemically cardiovert.
Apparently the meds they were giving me weren't working like we all hoped. So, now I'm on a different med regimen after this second hospital stay that seems to have stabilized my heart rate (110 instead of 180), and they're going to do the electrocardioversion again on Monday. They're hoping that it'll work this time with the new med regimen. This is what the cardiologist says. The internist is convinced that the electrocardioversion will be a waste of time since it didn't work before. He sent me home early to enjoy my own bed and home-cooked meals (minus salt and caffeine) instead of staying in the hospital all weekend just waiting for the procedure. I liked that idea. I'm taking it very easy. Trying not to have a heart attack after seeing the pharmacy receipt.
All the tests (CT, nuke CT, TEE, ultrasound of leg veins, etc.) are normal. My blood pressure is great. My cholesterol is wonderful. Only symptoms are breathlessness and fast heart rate. Once they gave me the Lasix to take care of the fluid, I could breathe just fine. I lost 11+ lbs of fluid!! But I couldn't even get out of hospital bed to the bathroom w/o my hr going up to 180.
The cardiologist is hoping that we can fix this and then start on strengthening my heart.
The internist tells me to apply for disability - I'll have this forever.
My husband has a co-worker who has A-Fib and they work as commercial electricians. That's hot, dirty, strenuous work sometimes.
The cardiologist gives me a little hope. The internist makes me think that I have to shut the door on my dreams.
Know of any docs out there with health problems like this?
I don't want to give up my dream!
I'm not asking for med advice here, or at least I don't think I am.
How much does your a-fib affect your day-to-day functioning? The answer choices are A.) not at all B.) Occasionally C.) Often D.) Always. If your answer is C or D, then you may have to seek a permanent solution to your condition or at least a solution that puts you in the A or B column. As you know, OB-Gyn is one of those specialties that puts you in the hospital at any hour of the day or night. If you have a condition that affects your day-to-day activities, you might have difficulty taking care of your patients. When you go to apply for a state license to practice medicine, the application will ask about any chronic illnesses that you have that may limit your practice. I am not sure where a-fib fits in that scheme.
When I lost the sight in my right eye(it's back now!), my first question to the ophthamologist was, should I seek another specialty since surgery requires a fairly high degree of visual acuity? His answer was a definitive, NO. There are lots of people out there operating with less vision that I have. If his answer had been different, I would have started to look into other residency programs. I will not put my patients at risk.
Only you can figure out how much this affects you and how much you can tolerate. After internship is over, the stress level gets better so that should not affect your function. Otherwise, listen to your cardiologist, who really knows your condition and keep on plugging away. I hope he or she finds something that will keep you out of the hospital.
Any hope for ablation? Have you seen someone who specializes in EPS? All cardiologists are not the same.
As Nat alluded to, only you can really make that decision based on how well you are able to function. On the surface right now it sounds like the answer might be no. I used to take care of people with pacemakers and defibrillators in a busy 11 cardiologist practice. What I saw in that office was that most people with uncontrollable afib seemed to end up with an AV ablation and a pacemaker. Most people with the ablations and pacemakers did well and some were extraordinary well. The problem is (or was as of a couple of years ago) that there just aren’t any really good medications for afib. On the other hand, no machine can work quite so well as our own hearts (also dealing with the coumadin) so if I was in your shoes I would try all that I could to see if I couldn’t get my own back to normal.
I agree with Nat and GED2MD especially on two points: 1) I would generally listen to a cardiologist vs. an internist, 2) If your cardiologist is a generalist I would definitely consider consulting with an electrophysiologist who really speciallizes in these types of problems.
The bottom line is that even if it cannot be controlled with medications, there are other means. And that even if you have to undergo a MAZE or ablation, it does not mean that you can’t continue to pursue your dreams. It will most likely mean some added headaches along the way, however.
Here is a link to a paper from this years NASPE (North American Society for Pacing and Electrophysiology)meating with some general info on the state of afib. You always have to be informed to make the best decisions. NASPE consensus paper on atrial fibrillation.
In fact, here is a link to NASPE’s home page with many links to a lot of information.NASPE Home page
I want to thank everyone for their very thorough and careful answers.
I've decided this from the wonderful advice I've gotten:
- I'm still too early in the game to worry - both with my A-Fib (since I've had it off and on only for less than a month - that I know of) and with schooling (just starting my sciences). I will continue with my studies to finish my Bachelors as long as I am able. I'm on my 2nd day back at school and feel just fine. I feel my blood flow through my body more now but I think a lot of that is psychological…
- If my A-Fib affects me the way it has the last 2 days while I'm taking meds, I'm more than happy to keep taking the meds. I also feel able to do most anything. The more active I am, the better I feel. My heart rate is fine. I sit down if I start to feel it racing.
- I will continue to pursue my studies to pursue med school (i.e. study of MCAT) because I don't know where I'll be next year. I don't want to just sit and do nothing.
- With such wonderful advice, I now know about other options of treatment for A-fib. (It's good to have an inside line!) I looked up A-fib on webmd and only found the electro and chemical cardioversion. I was really happy to hear about the possibility of ablation (may consider that down the road if I have to). Knowing that I have options makes this less scary. Also knowing that millions of Americans live with this everyday and survive…
I think one thing that is going to carry you far is your great attitude. Keep it up!
I second that!
Enjoy the journey- it took me a long time to realize that the traveling is just as much fun as the destination.