Diagnosed with AF 12 years ago, Nuala had unsuccessful cardioversions, a pulmonary vein isolation plus an ablation to regulate her heart rhythm before accepting AF as part of her life. Alongside a healthy diet and exercise, she takes digoxin, sotalol and warfarin.
Nuala thought she might be anaemic when 12 years ago she started to feel very tired and breathless when climbing stairs at work. After noticing her pulse racing a bit’ she consulted her GP who diagnosed AF and sent her to hospital. Intravenous drugs and then a cardioversion returned her heart to sinus rhythm for a few months before AF returned. Pushed by a drive in me to keep in sinus rhythm’, Nuala underwent 20-30 unsuccessful cardioversions and a pulmonary vein isolation over the next 8 years before reaching a decision with her cardiologist to remain in AF and regulate her heart rate rather than rhythm. She turned down the possibility of having an AV node ablation and pacemaker fitted because I’m too young for that and you can’t bring it back again’.
Nuala believes her AF is the result of a narrowing of the mitral valve; a condition she has had for over 25 years. At first she didn’t want to be on drugs for AF. She describes how she went through a grieving process for losing my independence’ and admits that part of me was in denial’. Today, however, her attitude has changed and she now accepts the need for medication to stabilise her heart rate. After finding that digoxin on its own caused her ankles and hands to swell, she was prescribed a combination of a lower dose digoxin and sotalol which works pretty well’.
Fear of stroke is Nuala’s biggest concern. She takes warfarin to protect her despite being anxious about its side effects, particularly bleeding. Regular blood tests have become easier, now requiring just a finger prick though Nuala has tentatively raised the possibility of having a home monitor. Her health professionals, however, are not so sure of it’. Aware of new anticoagulants coming onto the market, she is wary because there is no reversal if you do have a bleed’.
Nuala speaks very highly of the care she has received throughout her experience of AF. Her healthcare team have listened to her concerns, explained procedures, given advice by phone at any time, and supported her through periods of anxiety. Researching her condition on the internet and talking to medical professionals has helped Nuala make informed decisions about her treatment. Describing how having a heart condition can undermine self-esteem and bring about feelings of despair, she urges healthcare professionals to be more aware of the psychological impact which AF has on people’s lives.
For Nuala, having AF has forced me to look at my life’. She eats well, manages her stress and has a good warm relationship’ with her family. By modifying her diet, eating more chicken, fish and vegetarian meals than red meat, and giving up tea, fizzy drinks, and alcohol, she now feels healthier than ever. While unable to walk up hills or go to the gym because it would leave her too breathless, Nuala enjoys swimming and walking on the flat. While enjoying travelling, she is concerned at how discriminatory it is for people with AF to get travel insurance.
Nuala enjoyed a brief respite from AF recently when her heart went back into the feeling of slow and evenness of sinus rhythm’. Disappointingly, this was not to last. Accepting AF as part of her life has been a key part of moving on for Nuala. She describes her journey vividly: it was almost like a bully that was coming after me and I was running and running and running from it. But now the bully is living with me, at least now I know how to manage it’. She hopes that in the future stem cell research may offer hope for those living with AF.
Interview held 15/03/12