The Fortress Around My Heart

I saw my British neighbor outside his house and wandered over to chat. He and his wife are very friendly and neighborly in every sense of the word. Today we discussed the weather and the stability of our Internet connections, and I casually asked him if he knew of an English-speaking cardiologist in the area. It’s been nearly six months since my last EKG, and before I left Virginia , Dr. Caven told me I’d need to check in with a cardiologist in September.

Clive tells me he sees a cardiologist in Aalst , and it just happens to be the king’s cardiologist. Quite the recommendation. I’m accumulating an impressive list of medical practitioners—my chiropractor worked on Lance Armstrong during the Tour de France.

Clive has been seeing the royal cardiologist for a number of years. “I’ve got a heart rhythm problem,” he says.

“Me too! I’ve got atrial fibrillation” Clive expresses surprise and confirms this is his arrhythmia as well.

I tell him mine is sporadic, it comes and goes. This is how I reassure myself it’s not really serious. In my medical fantasies, I imagine it will one day disappear as unexpectedly as it showed up.

I tell Clive my a-fib is controlled with beta blockers, and I take a daily aspirin to reduce my stroke risk. I’m thinking to myself, “I’m fine, I’m safe, no worries.”

Clive confides he has had three mini strokes related to his heart, and he had been taking daily aspirin at the time. Now he’s graduated to warfarin, the dreaded blood thinner that requires all sorts of monitoring. Dr. Caven had told me that prescription blood-thinners are probably in my long-term forecast, but I wanted to believe I was going to be an exceptional patient, things would never reach that point.

I’m suddenly both more interested and less interested in hearing the rest of Clive’s story, which didn’t end with the mini strokes and warfarin.

No, he’s had two surgeries—ablations—where they send a probe in through an artery and cauterize a selected portion of the heart muscle to squelch irregular electrical impulses that cause the fibrillation. Neither procedure worked. He’s also had his heart shocked, and that unpleasant experience worked for all of 36 hours. He told me he recently read about a procedure that freezes rather than burns the faulty electrical pathways. He’s going to ask his doctor about that.

I think about Robert Frost’s famous poem that discusses whether the world will end by fire or ice…I feel like Grrrl-Interrupted. Clive’s adventures with atrial fibrillation have dismantled the carefully constructed fortress I’ve built around my heart. I laid all my rationalizations on the foundation that a healthy fit woman in her 40s can’t really have serious heart problems. I built a sturdy self-image on my low blood pressure and cholesterol levels. I felt protected by my hour-long walks and yoga practice, my reasonably healthy diet and weight.

But the truth hidden inside my cardiology house of cards is that it’s likely the medication I take twice daily will gradually become ineffective, that the occasional fluttering and irregular thumping in my chest will not stop on its own. Atrial fibrillation is a long-term, chronic condition that gets worse over time, something my head knew but my heart refused to acknowledge. My relationship with a-fib is not almost over, it’s only just starting.

Clive writes down his doctor’s contact info and hands me the white slip of paper. It feels like a bad fortune pulled from a cookie in a Chinese restaurant. I want to stuff it in my pocket, pretend I never read it. But then my hope preens its feathers and rises: maybe if I see the king’s cardiologist, I can pretend I’m a royal secure in a stone castle and not Grrrl-Interrupted waiting to get her rhythm back. Maybe if I try hard enough, I can still believe in happy endings and not dwell on my broken heart.

September 8, 2005