<p>I am not looking for medical advise online specifically, just really to calm my nerves until my husband sees his doctor either late next week or early the next week. My H is in his mid 50’s and has struggled with Atrial Fibrillation seven seperate times over the last 5 years with the last two episodes both occuring this year. He has been taking Toperol XL to keep his heart rate low and has a trusted and much loved Cardiologist who has always been honest and forth coming with us and has always been availabe to us on the weekends since we joke his AFib issues are Saturday’s only. His AFib has always responded to medication until May of this year when no matter what they tried, it continued to beat irregular. The decision was made to shock his heart back into a normal rhythm, a simple yet scary procedure that went well and had the desired result. He was told by his Cardiologist that if happened again and we had to resort to this procedure he would put him on Multaq and have him see an Electorcardiologist to more than likely have a surgery to make a permanent solution. Well it happened again yesterday, medication did not reverse it and he was shocked again and it went back into normal patterns. He started Multaq today.</p>
<p>Here is where we jump off track. Of course they always do blood work when he comes in and at his regular check ups. His blood work ups have always been normal. (last CBC May 2012) This time his white cell count was elevated, his platelets where elevated and his TSH was elevated (Thyroid, indicating Hypothyroidism) My husband has not been sick, has no cold symptoms, etc. He does not have a spleen and has not had one for almost 40 years. The doctor said that sometimes the white cells and platelets can spike durning AFib episodes, but then stressed they have never done that before. He offered to have him stay at the hospital for a full work up or come to the office next week for another CBC to see if the level went down and if they were up or the same, he would need to see a Hemotologist/Oncologist to see what’s up. I suspect (being pretty aware of body language) that the doctor was concerned but he did not stress hospitalization. My husband has a direct and real fear of any type of cancer. Lived through it with his first wife who lost her battle. I am a straight shooter and just want to know what I am dealing with. I told him to chill out and not focus on it until we could make the appointment on Wednesday so we could deal with the facts. Of course outside I am strong as a rock but on the inside I fear what we are facing. Any guesses or thoughts? I would like to hear best and worse case thoughts.</p>
<p>I know nothing about this but would like to sympathize with you about the difficulty of waiting what seems like a very long time to even be able to call for an appointment. </p>
<p>I know it’s a function of the holidays and the calendar – but I need an orthopedic appointment and when I called Thursday at 8:30 am and was told I couldn’t be seen until Wednesday I just lost it from pain and frustration. My internist <em>was</em> able to see me, make a tentative diagnosis, and provide drugs.</p>
<p>So hugs to you (as long as they can be virtual, I cannot move my right arm!). Hang in there collegeshopping and I hope that you’ll get in right away in the New Year and that all the levels go back to behaving themselves.</p>
<p>I think the wait is the main frustration. I too understand it is a function of the calendar. We could have stayed at the hospital but frankly I was afraid he would get something he didn’t go in with. Yesterday they said 40% of all people entering the ER with a fever were testing positive for flu. No spleen and the flu are really bad combo.</p>
<p>Elevated white count and platelet count can be a sign of many different things, many of them not serious. Hypothyroidism is absolutely easy peasy to treat and monitor. I’ve had it for 28 years. </p>
<p>As far as the aFib is concerned – DH has a pacemaker/defibrillator and, while he required an overnight stay for the implantation, it has been trouble-free since then. It also provides a huge amount of security. If they recommend it, go for it.</p>
<p>And I agree that the wait will feel interminable. Can you call your doc tomorrow and express concern about the wait? Maybe there’s something he can do to speed things up.</p>
<p>aFib may be a symptom on the hypothyroidism too. He may find that once he stabilizes his TSH the aFib goes away. I agree, for a chronic condition, hypothyroidism is “easy” to deal with–one little pill each day. What was his TSH? An elevated TSH can throw off all kinds of lab work. I would suggest getting him into an endocrinologist as soon as you can for a full work up. Symptoms of hypothyroidism are pretty vague too-dry skin, thinning hair, fatigue, all things people would assume are normal as we age.</p>
<p>I’m not a dr, just have had HT for 18 years…but I did sleep at a Holiday Inn :D.</p>
<p>Yes, it’s the not knowing that drives us crazy, made much worse by the internet - and by that I mean all the resources available including this forum. A few years back my regular doctor noticed something that he wasn’t sure of, so he referred me to a specialist, and my appointment was 1 week away. So I get on the internet and do my research and am already trying to decide if surgery or chemo will be the best treatment for my cancer… I mean, it must be cancer right? So I call the specialist and beg for an earlier appointment because I am so stressed out I can’t even sleep at night and might not last a full week. So I go in, he gives me a squeeze and says it’s nothing… a benign cyst perhaps or a blood vessel. They do a sonogram just to make sure. The not knowing will drive you nuts! So good luck with the diagnosis, and the waiting.</p>
<p>Sorry that I can’t give you any medical advice, just empathy. My H has been in Afib since August. I guess I have a lot to learn because those details that you mentioned are all new to me. We are still in the information gathering stage.</p>
<p>I’m a Cardiologist, and it sounds like your husband’s Cardiologist is doing the right thing. The abnormal TSH likely is not playing a role (typically a low TSH and hyperthyroidism cause Afib). As far as an elevated WBC, this is entirely nonspecific, unless the WBC count is way out of range.</p>
<p>I suspect that he procedure Atrial fibrillation ablation may have been discussed with your husband. But I think that a trial of a medication designed to maintain normal rhythm, such as Multaq ((Toprol really doesn’t do this as well) is reasonable. Please realize that the most effective medication for AFib works about 70% of the time, and ablation works anywhere from 70-80%. Unfortunately, there is no complete success with any chosen therapy. As for the recommendation about pacemaker- this does NOT treat atrial fibrillation, and neither does a defibrillator. Those devices are implanted for other reasons.</p>
<p>My husband has had problems with Afib for years, and always goes into Afib whenever he has any kind of infection. He’s had cardioversion (shocking the heart) several times, including twice while battling cdif infection. Perhaps your husband has a similar situation. I’ve known other people whose Afib is triggered by specific foods that they eat.</p>
<p>The last round, with also being prescribed Multaq, seems to have done the trick. One other factor was that he finally started treatment for sleep apnea.</p>
<p>The surgery that the doctor mentioned to you is probably ablation, which is a fairly minor and safe procedure (of course, that’s when it’s done to a stranger and not to your spouse!). For most people it can be done on an outpatient basis.</p>
<p>Try to concentrate on the hemotologist aspect of the specialist. Not all blood disorders are cancers, and not all are untreatable.</p>
<p>Also, in case your doc hasn’t already advised you of this, do not eat grapefruits or grapefruit products while on either Mutaq or amioderone. A substance found in grapefruits blocks the normal metabolic breakdown of those drugs (and many other drugs besides), which causes the levels of the drug in the body to get higher than your doc intended and leads to greater risk of side effects. </p>
<ol>
<li><p>The increase in white blood cells may indicate some sort of inflammation going on in the body. And inflammation can be a trigger of AFib episodes, so these factors may be linked.</p></li>
<li><p>The increase in platelets may well be related to the lack of a spleen. The spleen is the organ that normally destroys old platelets, and thus asplenic people often have elevated platelets.</p></li>
</ol>
<p>I think the issues with the blood count elevations is just that they are new. PsychoDad10 thanks for your words. We feel very comfortable with the partnership we have with our cardiologist and trust his treatment plans. Coureur we are unfortunately aware of the Multaq issues. We are also aware of grapefruit. We will continue to discuss the risk/rewards will all medications.</p>
<p>Multaq, in general, is a safer option than Amiodarone. The Grapefruit issue is probably not a real big deal unless your husband really loves to eat grapefruit, in which case that could be a problem-</p>