Well, after Monday's cardioversion going so well we were expecting Greg to feel great, but unfortunately that didn't happen. On Tuesday he slept for 16 hours straight and then felt completely exhausted when he woke up and again on Wednesday. He also gained nearly 5lbs of water weight in two days so we were concerned that he might've gone back into atrial fibrillation. However, we did get great news Wednesday that Greg's heart is still in a normal rhythm and that his potassium level was higher than when he'd left the hospital Monday! The doctors thought that Greg might've caught one of the many stomach bugs going around and that it was probably wiping him out.
This morning he had an appointment with the arrhythmia doctors. During the appointment we found out that Greg had some atrial flutter on Tuesday which is probably a more accurate explanation for why he was so exhausted. Atrial flutter is a less serious atrial arrhythmia than atrial fibrillation, though it can also cause blood clots and strokes. Greg already developed atrial flutter once last spring and they performed an atrial ablation (where they cauterize the neural pathway that is causing the arrhythmia) that fixed it. This atrial flutter could be caused by the same pathway or it could be caused from something else. If he continues to experience atrial flutter they will do another atrial ablation on him to stop it.
We also learned that once someone develops atrial fibrillation they are extremely likely to go back into it, even after a successful cardioversion because it isn't a permanent fix. It is one more symptom of Greg's heart getting so stretched out with fluid. The doctors are going to be watching Greg very carefully for any signs (increased weight gain, fatigue, shortness of breath) that he is back in atrial fib. This is kind of difficult because those are the symptoms he has from heart failure in general so it’s not easy to distinguish between them. But the doctors will be seeing him very often (including this Monday) to watch for any changes. If he does go back into atrial fib they will perform another cardioversion. The doctor explained that they will treat any atrial arrhythmias very aggressively because Greg's heart depends on his right atrium for the majority of its function since his right ventricle is in such bad shape.
Finally, we learned that they are going to be adjusting Greg's medications. He needs to be on a medication that helps prevent atrial arrhythmias as well as ventricular arrhythmias. The medication they will use is really potent and Greg will need to be admitted to the hospital for a few days for monitoring when they put him on it. At this point the plan is to wait until Greg is being admitted for other reasons (like low potassium, a heart catherization, or ablation) to minimize his trips to the hospital (which is so considerate of the doctors!) but again it'll depend on how things go.
So, this week didn't turn out as great as we had hoped, but we're learning a lot about atrial arrhythmias and we feel confident that Greg is getting really good care from his doctors. We are so blessed to live close to a hospital that is able to care for him with such excellence! God sure knew what he was doing when he brought us to Northern Virginia!
Thank you for continuing to pray for us, and for the many encouraging notes and cards we received this week! We are both really exhausted, emotionally as well as physically, from this journey and it's a boost to know that you all care so much for us. I have been feeling particularly drained lately and appreciate the encouragement I've received more than I can express on this blog! I'm hoping that nothing very exciting will happen next week and that you won't be hearing from me (no news is good news!), but I will keep you posted if anything major happens.