Will I ever fly again?

[sinophile888]

10 days ago, I was diagnosed with AF (atrial fibrillation) and spent four days in hospital. And now I am taking multiple medications including an anti-coagulant and something to slow my heart. My cardiologist has discussed shocking my heart back into a normal rhythm in about 5 weeks’ time.

I had to cancel a cruise which leaves in 3 days from now and a flight back from Hong Kong. I also have a trip east (from Perth) booked in July and another cruise out of Yokohama booked in October.

Has anyone been in a similar position? Did it all resolve itself? Will I ever fly again?

I am pretty disappointed with the situation but have at least followed the practice of travelling as often as I can.

 

[Cynicor]

You'll be more than able to fly. AF would be the most common regular arrhythmia going, and a significant proportion of the population will have it.

If cardioversion is successful, should be able to travel no issues in short order. If not, you will likely just need long term anticoagulaion (based on multiple factors, maybe not) but this can be easily sorted, especially with newer drugs that mean testing of coag levels is not required.

Make sure to discuss the issues with your cardio and GP, but bottom line is travel is nowhere near finished. One of my AF patients just went for his first oseas holiday in years, to Thailand, at 85, and is almost legal blind and can't walk very well.

I'm sure that you rate well, comparatively!

 

[scaredeycat]

You don't have to wait 5 weeks to be cardioverted. Ask your cardiologist to put you on one of the new anticoagulant medications that don't need blood tests and to make sure there are no blood clots hiding in your heart with a transoesophogeal echo. If the echo gives the all clear, you can be shocked out of AF straight away. Success in restoring rhythm is more likely if AF is of short duration. The only downside is that you need a tube stuck down your throat (under anaesthesia, of course). You'll still need to take medication afterwards, but you'll feel better if you're firing on all cylinders.
Oh, and you'll definitely fly again!


If it's worth doing, it's worth doing to excess

 

[harvyk]

I knew there was a reason why I held back offering my condolences before others had posted, it sounds like the answer to your question is a big resounding yes...

 

[Cynicor]

You don't have to wait 5 weeks to be cardioverted. Ask your cardiologist to put you on one of the new anticoagulant medications that don't need blood tests and to make sure there are no blood clots hiding in your heart with a transoesophogeal echo. If the echo gives the all clear, you can be shocked out of AF straight away. Success in restoring rhythm is more likely if AF is of short duration. The only downside is that you need a tube stuck down your throat (under anaesthesia, of course). You'll still need to take medication afterwards, but you'll feel better if you're firing on all cylinders.
Oh, and you'll definitely fly again!


If it's worth doing, it's worth doing to excess

I disagree with this. Not sure if you have more medical experience than I, but my recollection of a recent review was that wherever possible, it is best to wait rather than shock early. The NOACs do not change this one bit, so I would not "request" one from my doctor, I suggest one would discuss it.

Also, TOEs are not without their own risks and complications. Again, a discussion on pros and cons is worthwhile. Bearing in mind it is likely unknown how long this person has been in AF, the onset of symptoms does not necessarily correlate with the onset of the rhythm.

 

[scaredeycat]

AF provokes atrial remodelling, the extent of which determines the propensity for AF to recur. "AF begets AF". This is the rationale behind my policy of aggressively attempting to restore rhythm as quickly as possible.
Your point about transoesophogeal echo is reasonable - you wouldn't want an operator who only does a handful of cases a year "keeping their hand in" doing a procedure on you, especially if they don't know what they're looking for (like one or two individuals I've encountered over the years).
In any case, the vast majority of my patients tell me they feel better in rhythm than out of rhythm...


If it's worth doing, it's worth doing to excess

 

[sinophile888]

Thanks to everyone who replied to my post. I now feel a bit better about everything.

I think I had been in AF for at least 2 weeks before I saw my GP. I didn't put together shortness of breath, swollen ankles and a pounding in my heart as all being symptoms of one problem. Probably a bit silly on my part when I think about it. I am on one of the new anti-coagulants which don't need testing.

I had a chest x-ray and an MRI in hospital and an echo cardiogram last week. I see my cardiologist again tomorrow.

I am just feeling a bit sorry for myself. I am dreading the day that the Queen Mary 2 comes into Fremantle. Of course, all of this could have happened at sea or on the HKG -> PER flight.

I met a lady while I was in Fremantle Hospital who was told she had AF after she broke both of her wrists in a fall. It’s not often that you can’t find someone worse off than you.

 

[Cybella]

Being an avid cruiser and traveller myself, I felt your distress too....all the very best for tomorrow and here's to many more cruises and travel stories to come.

Thanks to everyone who replied to my post. I now feel a bit better about everything.

I think I had been in AF for at least 2 weeks before I saw my GP. I didn't put together shortness of breath, swollen ankles and a pounding in my heart as all being symptoms of one problem. Probably a bit silly on my part when I think about it. I am on one of the new anti-coagulants which don't need testing.

I had a chest x-ray and an MRI in hospital and an echo cardiogram last week. I see my cardiologist again tomorrow.

I am just feeling a bit sorry for myself. I am dreading the day that the Queen Mary 2 comes into Fremantle. Of course, all of this could have happened at sea or on the HKG -> PER flight.

I met a lady while I was in Fremantle Hospital who was told she had AF after she broke both of her wrists in a fall. It’s not often that you can’t find someone worse off than you.

 

[drron]

Well this week is one of the 8 weeks a year I work as a Cardiologist.AF is the commonest condition I see doing this.
Whether or not one goes for cardioversion depends on a lot of factors such as age,any other conditions etc.cardioversion is not indicated for everyone in AF.
But don't worry.Today I saw a fellow in his 80s who not only has had AF for many years but has had a mitral Valve replacement and a bypass and is on warfarin-the newer agents are not yet recommended for those with prosthetic valves.The good news he was just back from a 3 month RTW including a 28 day cruise on an upmarket cruise line.Not only that he was able to get insurance.
You will definitely be flying again.

 

[Boris spatsky]

Sounds like we need an 'Ask the Doc' thread

 

[Cynicor]

We'd probably all just argue among ourselves and the public would realise how much we do is based on personal experience rather than best evidence...

 

[kiwitripper64]

Hard luck. I hope you have a speedy recovery and lots more travel. I am just wondering what the community feels about how this will affect travel insurance? Will you need to disclose this ( probably) and will it make it harder to get travel insurance?

 

[landfall]

I have suffered from SVT (Super Ventricular Tachacardia) for the past twenty two years, I have been taking Betta Blockerss for this period of time also. The last time I had an attack (Dec 2012) at a beach BBQ on Bruny Island, I was lucky enough to have a friend at the BBQ who was a retired doctor. he felt my pulse and said I was in AF. By the time he had taken charge of our yacht and got us back to the main island (Tasmania) he had arranged for an ambulance to be dockside.

The paramedic was undecided what to do, I was going from AF to SVT, requiring different treatments.

Last year and this year so far, we have taken cruises to New Zealand from Singapore (24 days) Flown to China for ten day holiday, doing the Great Wall walk and off to Japan from Sydney on a cruise ship (22 days) then flying back to Sydney after eight days touring Japan by ourselves.

So to answer your question, YES there is life and flying after a heart condition. It's all in how you handle it mentally.

Good luck

Ken

 

[nickykim]

My mother was 60 when she was diagnosed with AF, she is now 84 and complains that AF slows her down as she power walks up the steep slope from the shopping centre to her house (St Helliers for those of you who know Auckland). She is fitter than me and still doesn't have to sit down to do up her shoe laces...

 

[Cynicor]

Hard luck. I hope you have a speedy recovery and lots more travel. I am just wondering what the community feels about how this will affect travel insurance? Will you need to disclose this ( probably) and will it make it harder to get travel insurance?

This is always answered by the PDS. I would imagine that arrhythmias are not covered, and it seems my TID pds shows the same.

 

[Simo]

Well this week is one of the 8 weeks a year I work as a Cardiologist.AF is the commonest condition I see doing this.
Whether or not one goes for cardioversion depends on a lot of factors such as age,any other conditions etc.cardioversion is not indicated for everyone in AF.
But don't worry.Today I saw a fellow in his 80s who not only has had AF for many years but has had a mitral Valve replacement and a bypass and is on warfarin-the newer agents are not yet recommended for those with prosthetic valves.The good news he was just back from a 3 month RTW including a 28 day cruise on an upmarket cruise line.Not only that he was able to get insurance.
You will definitely be flying again.

That is the answer...

Maybe you might have a higher Insurance Excess when travelling but that seems to be the only maybe issue.

 

[SamR]

I don't suffer from AF myself, but I am on anti coagulants for other reasons. I've found that if you just keep your pulmonary specialist informed, you can still fly with no problems. It just takes a bit of management.

I DO have a UK based colleague who does suffer from AF and it's never stopped him from long haul flying. As far as I can tell, he just stays on his meds and does INR tests where ever he ends up, as per usual. And he's just fine.

(And if you don't have one, buy your own INR machine. My lord, they are just fabulous. And very accurate. It's just a pinprick thing, like diabetics with a blood sugar monitor.)

 

[Cynicor]

I don't suffer from AF myself, but I am on anti coagulants for other reasons. I've found that if you just keep your pulmonary specialist informed, you can still fly with no problems. It just takes a bit of management.

I DO have a UK based colleague who does suffer from AF and it's never stopped him from long haul flying. As far as I can tell, he just stays on his meds and does INR tests where ever he ends up, as per usual. And he's just fine.

(And if you don't have one, buy your own INR machine. My lord, they are just fabulous. And very accurate. It's just a pinprick thing, like diabetics with a blood sugar monitor.)

Depending on your indication for anticoagulaion you may be able to use the newer ones that do not require INRs.

In the case of the OP's AF, it is almost certain they will be able to, and they are something I would be keen on in a frequent traveller.

 

[sinophile888]

Depending on your indication for anticoagulaion you may be able to use the newer ones that do not require INRs.

In the case of the OP's AF, it is almost certain they will be able to, and they are something I would be keen on in a frequent traveller.

Thanks, Cynicor. I am taking rivaroxiban which is apparently much easier to manage than warfarin. Still trying to get my medications sorted out; have had digoxin added to the mix. My next trip is to Melbourne in July so that should be plenty of time for everything to be sorted.

 

[Cynicor]

Great to hear, I hope you have a good trip.