McCarthy-Maybe Later; Natale- Let's Roll

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Posted by Mike Ware on September 15, 2002 at 21:00:45:

I spent 3 days this week at the CC being evaluated to see if I was a candidate for Maze per my request. As you may recall, I have lone, paroxysmal afib which just started 5 months ago. Dr. McCarthy referred my case to Dr. Hammer. I was run through various blood tests, two EKGs, ECG, chest xray, and a heart catherization (through the arm). Everything checked out fine, so I truly do have lone afib and I am a great candidate for surgery.

Dr. Hammer spent a couple of hours talking to me over the 3 days which was most surprising to me and very generous of him. He is a real encyclopedia of information on afib. He also set me up to meet Dr. Natale to discuss ablation to give me a balanced view of my options. I never did get to meet Dr. McCarthy as Dr. Hammer served as the go-between.

To make a long story short, Drs. Hammer/McCarthy decided that I should wait 6 months and maybe try some additional drug therapy to see what happens before they would recommend a Maze for me. Just as I expected, they had never had someone make the intellectual decison to go for the Maze so soon after developing afib especially without other heart problems that needed fixing. I guess they figured I needed to exhaust other options before undergoing Maze surgery. Of course, I believe, that delaying the inevitable only costs me more of my precious time doing what I love to do. Plus, trying other drugs also has risks, so waiting doesn't seem rationale to me. I guess I have to reach my wits end before qualifying. I can understand Drs Hammer and McCathy's reluctance to do open heart on me so soon s(hey, it scares me too), but I truly believe that's surgery is the way to go.

I spoke with Dr. Natale's nurse at length and then Dr. Natale rather briefly. They both believe that ablation is an immediate option for me. Dr. Natale is booked up until March 2003, but he has trained three other doctors in the procedure who are more readily available, so I have options to more forward with an ablation in the near term if I want one. If I got the numbers right, I heard them say they are experiencing 80% success with one try at ablation and with two tries, the success rate is 95%. This compares to 98% for the Maze, but with the Maze you are in the hospital 4-5 nights instead of just 1 night with ablation. The rates of stenosis that Dr. Natale is experiencing with ablation is also very impressive from the standpoint of being quite low compared to anything I have read about to date. The low success rate and significant stenosis rate were the things that drove me directly to the Maze. The new data (which I will confirm) gives me pause to consider ablation again.

FYI - I met Kristine at CC while I was there and see looked very good after her ablation. I was sorry to read tonight on this board about the pace maker wire problem. She was a pleasure to meet and talk to. I wish her all the best - she deserves it!

I will think about what I want to do for a week or two before deciding. Frankly, I am leaning towards ablation assuming the numbers I heard are right. I was really afraid of stenosis with ablation, but my fears are lessened now. Dr. Natale is using some new ablation equipment technology which is providing better results.

I learned that when you return for a 3 month checkup after an ablation, a second ablation is done if necessary. Any signs of stenosis are checked for at that time too.

Both Drs. Hammer and Natale recommended that I take Coumadin instead of aspirin until I have surgery. I wasn't thrilled to hear that. Also, I found that since I haven't been exercising as much since the afibs started, that my cholestrol has shot way up. Another reason to get surgery sooner than later.

So there you have it, I went to Cleveland with lots of questions and came back with a lot of answers, but also some new questions to research. I have a lot of new data to digest and to confirm. I will keep you posted. If anyone wants to email me for additonal details and insights, feel free to do so.

The CC has their processes and customer service honed to a fine art. Everyone was very friendly, efficient, and also well-qualified from what I could tell. The Guest House was comfortable and a convenient place to stay.

M.

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