Dear Dr. Gupta,
Tomorrow is my 62nd birthday and I am writing you to share my experience with AFib. 5 years ago, I retired from my job as a school counselor. At that time my blood pressure slightly rose into the high blood pressure zone so I was prescribed losartan. At age 60 I took up long distance running and my blood pressure and over health and fitness greatly improved. I have completed two half marathons and I enjoy running as it relaxes me. A few years ago, I also was diagnosed with an enlarged prostrate and was prescribed Tamsulosin 0.04mg. I am 6 feet tall and weigh 210 lbs. and somewhat active.
In March, my wife and I took a trip to India, Nepal, and Bhutan, however I became ill in India and we never made it to Nepal or Bhutan. In India we visited Varanasi, New Delhi, Agra, and Jaipur. On the way to Jaipur from Agra I developed fever, chills, and headache. In Samode a Dr. examined me at the hotel and diagnosed me with heat dehydration and gave me some electrolytes. The electrolytes were ineffective. I had also noticed that my urine was slightly dark despite all the water I was drinking. By the time we returned to Delhi, my wife was pleading with me to interrupt the trip and return home. In Delhi, a doctor came to our hotel and diagnosed me with a sinus infection and gave me some antibiotics which ended the awful headache. He recommended that I go to the hospital for a urinalysis. The results showed that I had blood in my urine. The doctor said that it could be a serious condition that needed to be addressed immediately. We notified our travel insurance company and thus began the process to clear to go home. We were unable to complete our trip to Nepal and Bhutan. Our travel insurance stipulated that a doctor complete a “Fit to Fly” form. The doctor came to the hotel to take vitals to complete this form. At this time, he noted that I had an irregular heartbeat and said that he could not clear me to fly. He advised that I go back to the hospital for an ECG. We went immediately.
The ECG at the Fortis Flt. Lt. Rajan Dhall Hospital determined I was in AFib and I was escorted to ICU. In ICU they Started an IV of antibiotics for the infection and cardarone to regulate my heart rate. I went through numerous tests for the infection, as they wanted to rule out dengue fever, malaria, and other illnesses that tourists get. Also, the Cardiologist determined, based on an echocardiogram, that I had inflammation in my heart and he suspected some sort of blockage and suggested I may need angioplasty when I returned home. While in ICU I had a bout with ICU Psychosis which the entire team of doctors tried to calm me down as I was hallucinating and threatening to pull the IV out of my neck. They gave me a sedative to calm down and the also caused my heartbeat to return to normal.
It took several more days in the hospital to bring down the fever. A CAT scan revealed that the infection originated in my bladder and moved to my kidneys. After 8 days in the hospital I was discharged and advised to see a cardiologist and urologist immediately upon arriving home. In addition, I developed a severe case of “eye floaters” in my left eye which impaired my vision.
Back home, my cardiologist quickly determined that I caused the AFib myself. During the trip and the weeks leading up to the trip I experienced difficulty in sleeping. While in India I ate vegetarian the whole week and had tons of energy as I was running around snapping photos and video of all that I was experiencing. I’ve always have been a bit of a hyperactive person and he claimed that the excessive running and lack of sleep contributed to the onset of AFIB. I believe the maybe the UTI may have contributed as well. After an EKG, a stress test, carotid artery test, and echocardiogram the doctor determined I have a perfectly healthy heart and that I had no restrictions but advised me from climbing high mountains or deep sea scuba diving. He encouraged me to slow down and advised me to learn to calm down. He prescribed Metoprolol Succ 50mg and Eliquis 5mg. I questioned him on the necessity of the medications due to a CHAD score of 1 because at one time I was diagnosed with high blood pressure (before I improved my fitness). His rationale for prescribing Eliquis was concern that tiny blood clots may be affecting my eye, thereby causing floaters. I returned for a follow up appointment complaining of palpitations asking him if I was experiencing AFib which he replied yes. He explained that he thought I would be able to tolerate the symptoms OK and suggested I may need to consider ablation if my symptoms become difficult to tolerate.
Since my last cardiologist appointment, I have been doing much research about AFib and have watched all of your videos, which have been incredibly helpful. I have gotten back to some running and practicing mindfulness and meditation daily. My palpitations have significantly decreased. If they are still occurring, I am not feeling them. I have noticed what may be symptoms of vagal afib. One evening I overindulged in spicy pizza and beer and a while later experienced a significant amount of palpitations. Shortly after my diagnosis, I frequently felt palpitations when I reclined in my chair or when I laid on my left side, but I am no longer feeling this. I eliminated caffeine coffee and I monitor my heart rate regularly with the apple watch.
All in all, I think I am doing better. Getting sick in India was a welcome wake up call for me and I am so grateful for the doctors and staff at the hospital in New Delhi for introducing my heart to my mind. Had I continued on to Kathmandu, I believe I would not have received such quality care. In retrospect, it appears that there were multiple factors that may have created the perfect storm for my illness in India. Pre-trip stress, lack of sleep, a UTI infection, and a new spicy Indian vegetarian diet. There was quite a bit of anxiety when I was diagnosed and I wish I had been counseled on what to expect with this condition. Is AFib with me the rest of my life? I am supposed to go for a follow-up appointment in October and I would love to be able to say I am free of AFib. Your videos and Facebook posts have been a life saver for me, and for that I thank you from the bottom of my heart. In addition, I thank you for allowing me to write to you to share my experience with AFib. It’s kind of cathartic. Please feel free to contact me if you have any questions or pearls of wisdom.
Daniel Van Coppenolle
Brownsville, Texas USA