George Y

Age at interview: 66
Age at diagnosis: 58
Brief Outline: George noticed a pain and tightness in his chest whilst driving one day, and the following night felt unwell when he went to bed. The next morning he went to A&E and was diagnosed with AF. He takes aspirin, amiodarone & propranolol.
Background: George is a retired teacher and lives with his wife. They have two grown up children. Ethnic background: White.

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Eight years ago George had a painful condition in his heel and his doctor advised him to elevate it. He later had a DVT. Once he had recovered from the DVT and returned to work, he noticed one day whilst driving that he had a pain and tightness in his chest. The following evening when lying down to go to sleep he felt unwell, and after a sleepless night he went to A&E at his local hospital. He was diagnosed with atrial fibrillation and the doctor explained to him what this was. He was transferred to a larger hospital and was put on an amiodarone drip, and when asleep that night, his heart returned to a normal rhythm. He was prescribed bisoprolol and took this medication for around a year. However, George felt that he had some unanswered questions and decided to see a private cardiologist. 

George continued to have episodes of AF, and each time would ask to be admitted to hospital. His AF usually started during the night and would wake him up, as he would experience a thumping sensation in his chest and could feel he had an irregular pulse. He would also get very cold and need to urinate more often when in AF. George lives in Northern Ireland, and has always been advised that he should present himself at the hospital before his AF had continued for 48 hours, as after that he may need to have a cardioversion to try and restore the normal rhythm of the heart. George would usually wait 24 hours at home with AF, and if he was still experiencing an episode at that time, he would go to hospital. He would then be given a one hour amiodarone drip; if that was not successful, he would then have a 23 hour drip. On all but one occasion (when George was diagnosed with acute glaucoma), his heart has reverted to normal sinus rhythm after 24 hours of drip, usually whilst he was asleep. George has also had an injection and tablets instead of a drip on some visits. Once when George was on holiday in England he went to A&E during an episode of AF, and says that he was told to come back if he was still having AF in six weeks’ time. 

George has tried a number of medications including sotalol and slozem, but found that his body adjusted to the dose and they stopped working as effectively. He now takes amiodarone (200mg once a day), propranolol (20 mg twice a day), and aspirin to reduce his risk of stroke. George experiences side effects from the amiodarone such as sensitivity to the sun, and needs to wear a hat when outside. He also has regular blood tests to check his thyroid, liver and kidney function. George stopped drinking tea, coffee, fizzy drinks and alcohol. He also finds that banana can give him palpitations, and stopped eating ice cream, chocolate and lemon after he was diagnosed with AF. He remembers when he was younger having palpitations after drinking alcohol. George is also interested to know whether the DVT and his glaucoma were connected to developing AF in any way. 

George says he feels very anxious and disappointed when he has an episode of AF, wondering whether he did something to bring it on, and wanting the episode to end. He is concerned about having a stroke, and when he learned that he had a condition to do with his heart, he decided that he did not want to return to work and retired. He says that he recognises that AF will not kill him, but finds the unpredictability and sudden nature of his episodes distressing. He also feels exhausted after an episode, which he feels must be because his heart has been working so hard. George is pleased to have not had an episode of AF for six months now, although is aware of his heart missing some beats at times. 

George had never heard of AF when he was diagnosed, and feels that with an ageing population, awareness of the condition should be raised. He feels that prevention of stroke (through identifying people with AF and putting them on anticoagulation) is better than caring for someone once they have had a stroke. George is very happy with the care he has received from the NHS, feeling they have never ‘made small’ of his case. He has found information from the Atrial Fibrillation Association useful, as well as speaking to a British Heart Foundation nurse on the telephone. He advises people with AF that it can be annoying and unpleasant to have AF, but it is something that can be lived with. ‘I live a good, full, active and free life. And so don’t let it tie you up and worry you.’ 

Interview held 19.9.12

George Y first experienced AF in bed one evening. The next day he admitted himself to A&E where he was diagnosed with AF.

Went home, normal afternoon, normal evening, normal night and went to bed, just the normal way. But once I put my head on the pillow, I wasn’t well. There was a complete different feeling within my body. I was a complete different person. An unexplainable event was happening and I didn’t know what it was. Spoke to my wife, weren’t sure what was wrong, all I could feel was, I don’t know how you would describe it, an inner an inner happening that you had no control over, that was, there was there was no pain, there was no headache, there was nothing like that. But this was just a suddenness and it was really as I rested my head on the pillow. Beforehand great, once that happened, bang.

So we waited all night. Didn’t sleep much, don’t think we slept at all but we maybe dozed in and out for fifteen minutes. Saturday morning we decided that I wasn’t feeling that well. I took my breakfast and then decided that I’d go to my local hospital. So we went down and I admitted myself to A and E and was taken in, and they put the monitor on me and the monitor was clicking away and then it would go [beeeeeeep] and everybody would look and would rush and if I did that, lifted my arm or anything it was [beeeeeeep] and they had they then sent for a consultant. The hospital was a small hospital, which has since closed. The consultant was not on duty and had to come in to see me, but he diagnosed, I would have been in the hospital about nine, half nineish a.m., and the consultant would have come at approximately one, twelve to one. And within fifteen minutes he was able to diagnose that I had this thing that I never heard of before, AF, atrial fibrillation. 

George Y believes years of anxiety may have contributed to his AF.

I would say, my GP says that it is what he would call, and he has been my GP this last thirty forty years so he knows me well enough, and he’s seen he’s seen my progression in life, it’s an anxiety problem that I have, have had, and will have, and that contributes to the AF trigger or the reason that I had it. It could be that it’s just like an elastic band, too much tension and then it [pings dum dum dum dum] goes off, or something suddenly comes. Now there are times, if somebody came through that door now I may jump [aaaargh] like that. That just, the tension is always under surface but not recognisable until something happens.

So there is that tension. I’m not denying it and it would contribute, I know it would contribute and, of course, if I feel something on my heart, and it’s only a murmur or a or an irregularity flicker, I go into worry mode or danger mode or anything like that and, therefore, if it had half an idea of coming it’s going to come that actual wee bit maybe because of that. So I would say, yes, that that does have a contributory factor.

George Y had a mixed response from his doctors when he wondered whether his AF was related to his glaucoma and a deep vein thrombosis (DVT).

I asked him, “Where did this come from? What started it? What could have happened?” And he, without saying it all with the one breath, but with one way or another, he said that the DVT could have had a contributing factor towards this initiating later and it happened, as I say, about eleven months after the DVT was in my leg.

But I was speaking to other eye people and they have said that there could be a relationship between glaucoma and AF. They in in their studies, they had come across some study that there may be some connection between one and the other. I know that whenever you go to the optician or the ophthalmologist, who gets your eyes, the new thing now is to get your eyes photographed and then they’re able to look at it and they’re able to see why your blood pressure or there’s a pressure and all this. So there maybe something, if it’s to do with blood pressure in there, you know, I don’t know. But they weren’t, some people were in doubt and said they’d never heard of that. “Oh I never heard of any connection between glaucoma and AF, no, no.” But one person said “Yes” and that’s the one person I’m mentioning in the sense that they said that they did hear it. All the other ones never said it but it could be that they mightn’t be that au fait with AF to know, you know, one way or another because these were just. It the acute is very rare. My mother had it. My brother, my uncle had it and my grandfather had it and they went blind with it.

George Y believes that greater attention should be given to AF.

This problem is not going to go away. As the population grows older, the it will get a bigger, it’ll become a bigger drain on the resources that are already there, and if it could be avoided or checked before it becomes the, in my sense, the dread of a stroke, it’d bring a lot of relief to peoples’ minds that they’re being caught, preventative is better than fighting it afterwards. It’ll cost less. It’ll be cost efficient and I I’ll be in favour of anything that would bring it to the notice of the public and to the lawmakers, the policy makers, whoever you like, and to yourself [laughs].
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