5 box Thorascoscope maze done on me 9/17

[Pete0629]

Hi all, just letting you all know I had this procedure done last Friday at Ohio State University Ross Heart Hospital. Dr Sirak is one of the innovators of this minimal invasive procedure. To save time and learn more you can go Ohioafib.com.

The advantage of this procedure over a typical ablation is it is much more affective on my condition, persistant, afib. It is more thorough and has better longterm results.It is definatley not a walk in the park. It is more invasive than the popular cardiac ablation, but as I said more affective on my type of afib, from the research I have done.

I am going to answer as many questions as I can in order to help people that are considering the procedure.

From what I have understood the procedure is " in network" in my United Healthcare insurance network. But I haven't seen any bills yet so only time will tell.
The worst part of the surgery is , to me, the feeling, weakness, and psycotic feeling from the  anethstetic and pain killers, I hate em! I actually hallucinated on them and they lingered for days. I did talk to others that have had surgery and they didn't have the same reaction , so it may be just me. I had essentially 2 nurses taking care of me in my room, one for general house keeping and care and the other a cardiac nurse. Both were professional and caring to the max. I also, being a single guy, developed a crush on my nurse in the OR, but I'll save that story for my buddys.
I have 10 incisions on my body, under my arms across my chest and 2 drain holes below my ribs. Small ones 1/2 inch long. Another concern I had was the whole BM issue, but I can report this morning I'm happy in that area.
I am on several meds for the shorterm. Mainly, as Dr Sirak told me, my heart has burns on it for the moment and need to heal, there will probably be inconsistant reactions to the inflammation over the next few weeks, but eventually I'll be taken off most or all the meds.

I'm not out playing tennis again, yet, but that is in my sites.

Any more questions? I'll be home the rest of the week and happy to let you know my experience.

Pete

[cindy707]

Hi Pete....that was pretty great reading thank you....so am i right to assume that this was a Wolfe Minimaze procedure because of the burning?  I do not understand one thing tho.....why does it take a week or so to basically get back on your feet after this procedure?  I know with the catheter ablation we were up and around the same day and alot of people go back to work the following day...i know i popped back within a day....is it because of the surgical incisions or the way the procedure is done on the heart?  The other question that i guess i have is why so many medications?  You said the doc has you on i believe 4 or 5 different meds for an unforseeable length of time...i am just wondering why...i know with the cath ablation no meds are dispensed after the procedure unless we have some rough spots after...and the other question i guess i have is is burning the heart the normal procedure because i know in a cath. ablation the doctors choice of way to go is RF or freezing and am wondering if the incisions that the doc physically puts into the heart has anything to do with the choice to burn.  I am so hoping that this procedure will be a success for you Pete....to me no one deserves it more with everything that you went thru...thanks for the education tho......and what the heck happened to Angel_001 she was your biggest cheerleader in your having the maze procedure done.......stay well Pete and go get em..........

[annie1724]

I'm so glad to hear that your procedure was a success.  I have a question too.  From your research, and from your conversations with the doctor, is there more long term success with the five box procedure than with the typical catheter ablation?  Also, how do the risks with each procedure compare?  I'm sure your doctor discussed those risks with you.  I know there are risks with any medical procedure, but I wondered if there were fewer risks with the five box.

Again, glad things went so well for you!

[Angel_001]

Hi Pete!

Great summery and very educational!  I have a question too:  have you experienced any intercostal pain from your incision sites??  I ve heard some patients who have had thoracoscopic surgery via intercostals (thoracotomy) its very painful.  I was surprised to see that you had 10 small incision sites.  Are they very big or noticable???  My friend who had it done several years ago had 3 on the right and 4 on the left just under her arm pits and you cant even notice them.  As far as the BM concerns.......I hear you there!  I stayed on an over the counter stool softner and laxitive for 3 mo. after my second child this summer and soo glad I did since the recovery process has been tough.  If you are having any thorasic discomfort - taking a OTC wouldnt be a bad idea - it will keep you regular and subside any straining you might have with BM's (esp post anesthesia constipation).  You mentioned that you got to talk so some other past patients who had the surgery....what were the pro's/con's that you took away from talking with them???
No hurry on any responses.......get some rest!

Keeping you in our thoughts....
Angel :)

[Pete0629]

Hey there

I'll try to answer all the questions you all asked.

The 5 box is more invasive( incessions, anesthetic,) than the catheter ablation, less than the cox minimaze, so it is more painful and takes longer to heal. I chose it over catheter because it has a better " cure rate" for the persistant afib I had than the catheter ablation and ultimately cheaper since I would have in all likelyhood had the catheter at least twice, according to statistics. It is taking me a week to get back because it is surgery. They have cut several areas of my chest to insert the scopes into my body to do the procedure. Combine that with the anesthtic and new meds and it knocks you for a loop, temporarily.
I am on the meds, warifin, beta blocker, diuretic to handle some of the post operative issues, fluids and the help the heart regulate rate and rhythum while it heals. It is going to take some time for my heart to function normally. So during the healing process the meds just make it easier. Cindy, I know 2 people that had catheter ablation that took all of the meds I'm taking now afterward for the same reasons I am taking them. I believe it's just a way to help things along. Also my doctor made the statement about " burning" the heart during this procedure. I'm going to ask him about that, because I think also the freezing is a method of choice these days. I'll let you know what I find out about that.
Annie--The risk comparisons between the 5 box and catheter are answered at ohioafib.com. But my search showed a lower risk, stroke, bleeding and higher success rate with the 5 box. Check it out though.
Angel--I have not felt a lot of pain from the incesion sites yet. Actually the doctor explained and I'm paraphrasing, he actually freezes the incision areas that will paralyze the area for about a month. That way you feel very little pain during the healing process. I couldn't explain it in detail but so far not a lot of pain. I didn't talk to other who have had the 5 box done. I only talked to others that had been under anesthetic for other surgerys. They said they didn't experience what I had. I am also curious why I have the incision across my chest.

Well, I'm still in the healing process, I do have some tightness in my chest which I'm going to ask the doctor about today, I e-mail him daily. He wants to keep updated on my progress. I did take all the bandages off yesterday and Angel, right now, it looks like someone attacked me with numbchucks that had razor blades on the end of them. But I think in the long run there won't be any real noticable scarring. For the most part I'm doing ok. I am an impatient guy and want to be back to 100% now. I'm trying to accept the fact it's going to take some time.

You all have a great day and let me know if you need anything else. This is actually helping me so I appreciate the concern.

Pete

[Angel_001]

Hi Pete!
Its good to see you still have your sense of humor....numbchucks..lol.
Thanks for the update!  Take it easy and keep thinking about that back-swing :)
Cheers
Angel

[Pete0629]

That's me, mr humor! At this stage it is good to keep a sense of humor. I'm stuck at home recouperating and not really able to do a lot. I want it to be 2 weeks from now i.e. Afib gone and able to do my workouts again!

[Pete0629]

Well everybody I have told you guys about the positive side of the procedure so far, I week today. Let me tell you about whats been going on the last couple of days.

I am feeling up and down physically. Yesterday I woke up feeling great, for about 1/2 hr. I then felt kinda weak so I sat down. I continued to sit for the next 7 hours. Weak, dizzy and generally felt pretty crappy. In the afternoon my heart jumped up to 108 bpm and has stayed there to this minute. My face is ashn and I am foggy headed.

I'm hoping for an improvement later since my daughter will be home from school later today.

UGH!!

Pete

[annie1724]

Hi Pete,
Have you contacted Dr. Sirak or his office to see if what you are experiencing is a normal part of recovery?  I think it's worth a phone call just to be sure.

Unfortunately you are a long way from your doctor, so I'm sure you want to catch any potential problem early.  

And maybe it's all to be expected, considering everything you went through!  But  no matter what's wrong with me, I always feel a little better once I hear that my symptoms (whatever they are!) are normal.
Annie

[Pete0629]

Hi Annie
Yes I have been in touch with Dr Sirak. He has changed my rythum med to see about getting my heart back to NSR, so far it hasn't worked.

It's 6:52am and I'm feeling a little better so far. Although I'm back in afib the tighness in my chest( apracarditis) I believe is what it's called, isn't as harsh as it was yesterday, so far.

[annie1724]

Hi Pete,
I am so sorry to hear that you are back in afib.  I'm sure you must be very upset and disappointed.  

Did Dr. Sirak say that this can be expected after the procedure?  Because I've read so many postings on this site from people who have had catheter ablations for afib and apparently it is quite common to still have episodes of afib after that procecure.  I guess the heart is just so irritated and swollen that it needs time to heal before everything calms down.  I've read several postings from people who needed stronger meds or even a cardioversion to set things straight after the ablation.  Hopefully your heart will stop being so stubborn and will settle down for you soon!

I'm sure you're also disappointed to be feeling poorly when your daughter is home from school, but this gives her the chance to take care of dear old dad!  I'm sure she won't mind and will be glad she is there for you.  It will be nice to have someone with you....it's always worse to stew about these things by ourselves!  Try to have a nice visit and hopefully it will take your mind off of your stubborn heart!

Annie

[LindaTX]

Hey there, Pete.  I can just about say I know how you feel!  Had mine Wed morn and juast got oyut of the hospital 2 hrs ago.  Have had major shortness of breath and was given lassix.  Had chest tightness but today, the 4th day, getting a little better.   I've only had 12 hrs of NSR so far but I'm like you...wish it were 2 wks from now.  Sounds like we're experiencing a lot of the same.  The worst for me is not feeling like I can take good breaths. Just wanted to say, Pete, I'm right there with ya!

[Pete0629]

Hey there,

Well I think you are progressing faster/better than me. I'm still out of rythum at 108 bpm. Been out for about 4-5 days now. I'm finally starting to feel better just from the fact of the chest tightness has subsided some, not completely  but some. I'm really back where I was before all this sh-- happened, except my rythum is actually faster than it was before.

Hope you continue on the road to better health Linda.

Pete

[Pete0629]

Annie

It has been nice to have my daughter home this weekend. She went to the store for me. We also watched some of a CUBS baseball game yesterday. My son was at the game, actually across the street on one of the rooftops, at a bachelor party for 2 of his friends. We joked yesterday morning via facebook, that he was going to end up in Cook County jail. He and his friends I've known since they were all kids. It's nice to see them all in youthful healthy young adulthood.

But yeah Annie I have tried not to stew about where I'm at now in the healing process, but I won't lie, it's not easy. You just hate to think you've made no progress after a lot of pain and cost, both to the insurance company and myself. Anyway, I'm keeping my fingers crossed for both Linda and myself. This isn't as easy as you read about.

See ya
Pete

[annie1724]

Hey Pete,

I can understand your frustration completely.  What does Dr. Sirak say about this?  Cause he seems (from what you've posted) to be very reachable and sympathetic and easy to talk to .  So does he say that he often sees his patients redevelop afib as they heal?  Is this just part of the whole process and it's to be expected?  Cause if he tells you that, as difficult as it may be to go through it, at least you would know there is light at the end of the tunnel so to speak.  I think Cindy even mentioned in one of her posts that she had to be cardioverted from afib after her ablation, but then that did the trick and she's been ok since.  

Good luck and please keep us updated cause we care!

[Pete0629]

Hi annie

[Pete0629]

Annie, sorry about that I hit the wrong button. I happen to be on line when the e-mail came through. Yes I spoke to Dr Sirak this morning,. He increased the dosage of the sotolol I'm taking to about the max dosage. If that doesn't work in a day or so I'll have to be cardioverted. I'm not looking forward to that as my chest already hurts!
But I'll have to do it to get back I suppose. I asked him about whether this is typical and he said sometimes it has to be helped back. So I just have to be more patient.

Pete

[annie1724]

Patience is tough, especially with our health.  It's just good to hear that the Dr. is not alarmed and said that sometimes this happens.  No one wants to be the "sometimes", but it's encouraging to hear that it does occassionally require a little extra help to get back on track.  Hoping the sotolol does the trick without the cardioversion!

Keep us posted!  We're all pulling for you!

[Angel_001]

Sorry to hear you're having a tough go :( it sounds like you've done a great job staying on top of rhthym management and communication with Dr Sirak.  Annie gives great insight and advice.  I've known of several Afibers who've had ablations needed cardioverted.  I've noticed a lot of ablated patients - it takes 6 months to stablize (3 months at best). You figure, given your surgery cardioversion is a walk in the park...theoretically cardioversions post ablation could be more successful in maintaining NSR b/c those substrates that lend themselves to AF are eliminated.  The hight of inflamation phases peaks upto 72 hrs post "op".  Once the inflmatory process subsides (6-8 weeks) hopefully you will be feeling better. Till then your - Try to rest - allow your body to regain its strength - you heart/body has been through a lot.
Keeping you in my thoughts and prayers!
Cheers
Angel

[Angel_001]

Hi Linda

Did you have the same procedure that Pete had by Dr Sirak???

How have you been doing?  What's your take on the procedure??

Have a great day!
Angel

[LindaTX]

Hey, I was just coming on to ask Pete about his sotalol dosage.  Mine is 120 mg twice a day...never took it before...having a lot of breathing difficulties....out of rhythm most of the time.  My husband just called the office to find out why they prescribled me digoxin and sotalol both...by different dr's.  She said she'd get back with us.  I seem to be doing fine in the mornings with no activity...then as the day goes on I get the shortness of breath, higher pulse rate and arrhythmia.  Hope this all subsides soon.

[Pete0629]

Hey Linda

Hope all is well with you. My dosage of sotalol is the same as yours. My doc told me that's the maximum dosage. He is still trying to convert me back to NSR this way. My afib is constant since last Friday morning. He said if it doesn't convert today ot tomorrow he's going to have my cardiologist cardioconvert me. I'm on 2 different beta blockers also. I'm feeling way better the last couple of days. Although, with me, I have those darned incesions to deal with, ouch. But I am almost back to normal, for me anyway. I just hope now this afib turns to NSR soon.

Like I said hope you're doing better and keep me informed.

Pete

[Pete0629]

Hi Angel

Like I told Linda I'm way better the last couple of days. Still some pain from the incision sites. You know I found a video in stopafib.org that shows, pretty close anyway, to the procedure I had done. I watched it the other night along with a Q&A from the EP and Cardiologist that does the procedures. They answered and reinforced a lot of questions I had. If you want to see it go to the video Thoroscocope maze video it's pretty cool, at last from someone that had it done.

I realize getting back to longterm NSR may take time. I'm settling in for the long hall I suppose. I am just sooo happy I'm feeling stronger again. Even though my daughter and my son have been very helpful through this, I'm a pretty independant guy. I don't like it when I have to depend on others, so my freedom from all that lately has been a breath of fresh air.
As far as the cardioconversion, yeah it's normally not a big deal but with my chest feeling like it has a giant scab across it, I'm not looking forward to anyone sticking those damn pads to it and rrriiippping them off afterward.

Hey you all have a great day and one last thing angel, it was nice meeting you.

Pete

[LindaTX]

I feel like I'm on a roller coaster.  Sometimes I feel  not too bad and other times, most of the time, I feel weak and breathless.  The Dr's office said I wasn't supposed to be prescribed the digoxin, just the sotalol...so maybe that will make a difference.  I have to go to my regular dr. tomorrow for a coumadin check and they are going to do an ekg to make sure all looks ok.  Then I will be getting a monitor in the mail soon to check once a wk.  I feel like Pete and I are probably both getting slowly better, thank God.

[Angel_001]

Hi Pete!
Its wonderful to have met you too!  
Thank you for the heads up on the video - I will certianly check it out.
Its great that your kids could be there during your recovery.  All those years you love and supported them they get a chance to return the favor.
I hope you convert soon to NSR without cardioversion!  
Keep getting stronger - Semper Fi
Cheers
Angel