Gail

Gail first felt unwell 18 years ago, and then had occasional episodes of AF. Her symptoms got more frequent and troubling 3 years ago. Flecainide and bisoprolol gave her side effects. Gail has had 2 ablations (the second successful) and takes warfarin.

When Gail surfaced after scuba diving eighteen years ago, she got cold and noticed she had an irregular pulse. For the next fifteen years, she had symptoms such as palpitations, breathlessness and fatigue only occasionally, a few times a year for a few hours at most. Around eight years ago she managed to register an episode of her paroxysmal AF on an ECG machine whilst at work as a GP, but since the episodes were not too debilitating, she carried on life as normal.

Around four years ago Gail’s AF episodes became more frequent, but still tolerable. She felt concerned and irritated when having symptoms, but then would feel better and again carry on as usual. However, three years ago her AF really started to kick in;, happening once a week, lasting from half a day to three days at a time. Gail saw a cardiologist and was prescribed medication. Propafenone and dronedarone did not work for Gail, but flecainide and bisoprolol were effective in terminating the episodes. However, the medication would leave her feeling spaced out;, miserable; and not functioning well for a day or so.

Gail says she tried to endure her symptoms, as well as timing when she took medication, including only taking medication at night for episodes, as she knew the side effects would happen when she was asleep. She also tried not taking the medication at all, but still felt unwell. Gail felt as if she had to pay for the benefit of having episodes stopped through taking medication. She did notice that the symptoms and side effects were less noticeable if she was able to distract herself, such as in a social situation. Gail recalls feeling disappointed at having AF, as she had always considered herself to be fit and active, and felt like her body was failing her.

For the last two years, Gail had episodes of AF every other day, and felt that she was either recovering from an episode or experiencing medication side effects. Although by this time she had retired from working as a GP, she still worked part-time as a counsellor, but felt as if she was pushing through a fog; when at work. Due to AF and other reasons, she decided earlier this year to stop work. Her cardiologist had previously mentioned the possibility of an ablation procedure, but was cautious and so was Gail. However, Gail reached a point where she felt she could not continue with the episodes as they were, and decided to have an ablation. She started taking warfarin before her first ablation and continues to take it. She has a finger prick blood test at a hospital outreach clinic at her local GP surgery, and finds the monitoring process quick and efficient. She carries a warfarin alert card in her wallet.

Gail’s first ablation October last year was not successful. Whilst she was warned that it may not be, she was still disappointed. She says that she felt battered; and traumatised; after the ablation. She had a minor complication after the surgery, and felt it was not acknowledged by the nurses as something scary for her, as it was routine for them. She described the hospital as feeling like a sausage machine;, and that to some extent, she felt that the surgeons viewed her as a machine to work on, rather than taking her personal experience into account.

Gail had a second ablation in April this year, and in the last few weeks has noticed her episodes are less frequent (now two or three times a week), often at night, and usually stop of their own accord within a few hours. Episodes can wake her up, but she can also sleep during one. She is more aware of her symptoms when lying down, and says that palpitations in her chest feel like there is a bird in there jumping around;. Gail has reduced the number of times she takes medication and says she feels so much better not having side effects. Her episodes are mostly random and happen without warning, but getting cold and burping are triggers for Gail, as is unintentionally holding her breath.

Gail says that I haven’t had my life and haven’t been myself; for the last two years. Until six months ago, she continued to push herself to do the same things as she did not want her AF to interfere with her life. However, after feeling particularly unwell whilst driving one day, she realised that she would benefit from doing things in different ways. She says that she started to change her mental approach, and began to come to terms with not being as active as she once was, doing other enjoyable activities and less strenuous physical hobbies.

Gail reminds medical professionals that patient experiences of a condition are very significant, hugely varied and personal. She feels these experiences should be acknowledged, and that just a few questions about how a person is affected, how they feel, and trying to understand a person as a whole is what is needed. She reminds practitioners that it is not just a body that needs adjusting, but that people’s fears and expectations are also important in treatment. She found her ablation procedures quite traumatic, and took longer to recover than she was told it might take. When having an episode of AF in the past, Gail has felt that guidance on how long to let an episode go on for before going to hospital has been unclear. When attending the hospital for outpatient appointments, she has found the amount of time waiting to see a specialist particularly long. However, Gail is keen to stress that she is an ardent supporter of the NHS and the services it provides to all. She has found being a patient has given her insight into the experiences of her previous patients.

Gail advises people with AF to take the condition seriously and not to brush symptoms aside, and to be kind to themselves and tell others how they are feeling. She has found it useful to read other people’s experiences of AF online.
She advises friends and family that even though someone may look well, on the inside they may be feeling ill. She says that AF can be unpredictable and therefore may affect plans, so to be supportive of the person if they say they are feeling unwell.

Regarding the future, Gail is cautiously optimistic and hopeful that her symptoms will continue to improve as a result of her second ablation. She says that on the one hand she dreads AF being a lifelong condition, but on the other hand she is glad that it makes her live more day to day, and appreciate any day that she does feel well.

Interview held 21.8.12

Gail prefers to speak to her cardiologist, rather than searching for information on the internet.

Age at interview 62

Gender Female

Age at diagnosis 44

Gail stressed the need to find a balance between encouraging people with AF to do things while not pushing them too far.

Age at interview 62

Gender Female

Age at diagnosis 44

Gail, a retired GP, felt that health professionals need to know about each person’s experiences.

Age at interview 62

Gender Female

Age at diagnosis 44

Gail is very happy with the care she has received and is a total supporter’ of the NHS.

Age at interview 62

Gender Female

Age at diagnosis 44

Gail felt that her cardiologist did not acknowledge her as a person.

Age at interview 62

Gender Female

Age at diagnosis 44

Gail explained how employers may find it difficult to accommodate the unpredictable nature of AF.

Age at interview 62

Gender Female

Age at diagnosis 44

Although Gail considers her AF a lifelong problem’ which may shorten her lifespan, she believes it makes her appreciate life more.

Age at interview 62

Gender Female

Age at diagnosis 44

Gail was pleased that her second ablation appeared to be working. The procedure left her feeling traumatised.

Age at interview 62

Gender Female

Age at diagnosis 44

Gail researched possible causes and found a tenuous link with scuba diving.

Age at interview 62

Gender Female

Age at diagnosis 44

Struggling with the effects of AF and hangovers’ from her medication, Gail reluctantly decided to give up her part-time work.

Age at interview 62

Gender Female

Age at diagnosis 44