You could say this has been a very interesting summer. And one I would not like to repeat.
As many of you know, I have always had a very critical view of Apple as a company and the way their business operates — one that has mellowed from outright distaste to acknowledgement of their usefulness in the last eight years or so, since I became a routine iPhone and iPad customer, and an occasional but reluctant Mac user.
I did not have the sense of feverish dedication many consumers have to their products. Sure, I used them, but in the sense that as someone who writes about these things, it was a matter of necessity to stay educated about all the mobile technology platforms.
I have never felt a sense of loyalty to the company, or appreciation in any sense. If anything, I was the loyal opposition.
Back in January, I decided that I needed a smartwatch.
“Needed” is probably too strong a word, I just wanted to get in on the wearables thing. My friends all were using them and I was intrigued about what kinds of apps were available.
So I bought a reconditioned 42mm Apple Watch Nike+ Series 2 from the Apple Outlet for $240.
I wasn’t going to pay full price for a device that I considered experimental, accessorized tech that I had a good chance of just stuffing in a drawer after it outlived its initial novelty.
For the first several months my feelings were just that. For my use case, this was an accessory that didn’t provide a lot of value above iPhone notifications. Interesting, sometimes useful, but not a must-have. And it was annoying to have to take it off to charge it every other day.
I wasn’t committed to it. I was also playing with the Samsung Gear and Android Wear as well. I felt they were about the same in levels of utility.
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That all changed in May.
Like many other Apple Watch users, I got an email from the company asking if I would be willing to participate in the Apple Heart Study, a large data-gathering exercise they and Stanford University were partnered in.
Big Data? IoT? Cloud analytics? Sounded right up my alley. I installed the iPhone app and then promptly forgot about it.
Then, a few days later, this happened.
Needless to say, I felt rather alarmed by this.
I followed the app’s instructions. When I clicked on “Call a Doctor” I was immediately patched through, via FaceTime video call, to one of Stanford’s cardiologists. We discussed the results.
While they could not be absolutely certain, there were indications I might have Atrial Fibrillation or “Afib”, which is a common form of heart arrhythmia that affects tens of millions of people.
It often goes undiagnosed, because in many cases, it is paroxysmal in nature — it comes and goes, often set off by “triggers” such as by the use of stimulants, alcohol and other substances.
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But sometimes it just plain happens.
It’s not the kind of thing that comes up in an EKG unless it is actually happening when the test is occurring. I’ve had EKGs a number of times, and there was never any indication anything was wrong.
I’ve even had heart tests as a precondition for having bariatric surgery four years ago, and been under general anesthesia, with no adverse results of any kind.
Unlike heart disease, where the risk is congestive heart failure, the risk of Afib is a stroke, because the abnormal rhythm can cause a blood clot.
The Stanford doctor wanted these results confirmed, so they decided to send me an ePatch, a small device you tape to your chest for a week. It collects a broader set of data.
After a week, I sent it back to Stanford. After several days, I had another FaceTime consultation with them.
It turned out that during the time the ePatch was on me, I was in Afib 28 percent of the time — there was also a period of 21 hours where basically, it was happening constantly. I was told to go discuss this with my doctor right away, and they would forward the data to him for additional review.
My doctor sent me in for an echocardiogram, which is a type of sonogram that is used to get some imagery of heart function and also to see if there are physical abnormalities.
The conclusion of this was that I did not have any heart disease, and all other physical aspects of the heart were basically fine for a 49-year-old male, but my left atrium had a mild enlargement.
This probably was caused by many years of being morbidly obese and having high blood pressure. I lost 160lbs, and am now much healthier, but that damage doesn’t just repair itself.
However, people who are otherwise perfectly healthy can also get it, and it’s also common among athletes that over-exercise. And you can also be born with this.
Another thing — a few years ago, after my bariatric surgery and loosing all that weight, I was taken off my CPAP machine because it was assumed I no longer had sleep apnea.
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Well, guess what — that was a bad idea. I was given another sleep study and they found out I still had sleep apnea.
By not using the device and being fatigued due to lack of restful sleep, it was possibly increasing the likelihood of Afib triggers and causing increased blood pressure — among other things. Back on the CPAP machine at night for me.
A word to the wise: If you are diagnosed with sleep apnea, be compliant and use your machine. Because all sorts of things will get screwed up if you do not.
My doctor sent me to a specialist, Dr. Murray Rosenbaum, an electrophysiologist in residence at Boca Raton Regional Hospital. It’s a huge practice that works with a lot of patients down here.
Rosenbaum told me I was extremely lucky the Apple Watch picked up the Afib relatively early. In a few years, the likelihood of stroke would be greater because the condition would get worse.
This has probably been happening for years, and the condition almost certainly had a negative impact on my life because it made me tired much more easily and also, it probably was making me anxious all the time. Anxiety could also be setting it off, in a vicious cycle.
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There were two courses of treatment for this. The first option is to take a medication called Flecainide — which only works in about half of the patients that take it, and it can have unpleasant side effects. I would also have to take a blood thinner, Eliquis for the rest of my life as a precaution against pulmonary embolism caused by blood clots.
Alternatively, have a procedure known as Cardiac Ablation. They use catheters inserted into the veins located in your groin, and go all the way up into the heart, where they use radiofrequency energy to disrupt the faulty connections causing the arrhythmia.
They touch anywhere between 50 and 70 points, using a lot of technology to help them guide the way and very precisely hit their targets.
During the procedure, a 3D image, created by computed tomography chest scans a few weeks before in a lab, is merged with a live X-ray to create an extremely detailed navigational map. They also use an echo method known as TEE using a sensor pushed down the throat, to check for potential obstructions in the heart valves.
It’s a very Star Trek-type low-invasive procedure; they knock you out using general anesthesia and you remember nothing. Basically, they are giving your heart an electrical tune-up as if they were adjusting fuel injection engine timings in your car. It takes about three hours.
They have a big team of people that assist the electrophysiologist that sits in a control room and stare at monitors in heavy concentration while they do this. They might as well be launching rockets to Mars in there.
But once it is done, you’re good. You can soon go off the blood thinner and Flecainide. In most cases, they send you home the next morning.
I initially went the drug route. Flecainide made me dizzy and tired. I was unable to concentrate on complex tasks. I couldn’t write for ZDNet, and I couldn’t do my day job. I was a mess.
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So after a few weeks, we decided to go for the ablation. Prior to that, I had to get that CT scan, which is done with contrast, and feels really weird when they inject it.
I also had to get a small device called an implantable loop recorder injected into my left breast which does much of what the ePatch does, but it communicates wirelessly to an IoT thing that sits by my bed. Late at night, while I am asleep, it uploads data to Rosenbaum’s office. The battery in it lasts for 3 years.
To say that the ramp up to this thing made me an emotional wreck is an understatement. My entire summer was consumed with worrying about this stuff.
I had the ablation in late August. I’m still in the recovery phase, and my doctors will be monitoring me over the next few years using the loop implant as to how often the Afib comes back and when. It will take a few months before the arrhythmia subsides and my heart rate returns to normal levels.
I had a huge team of very talented and attentive people at Boca Regional and I’m incredibly grateful to them. Rosenbaum and his associates at Cardiac Arrhythmia Service are extremely talented and their bedside manner is of the best I’ve ever experienced.
Ultimately, though, I owe my life to my Apple Watch. Because it started this whole machine rolling. And I was very lucky to have my Afib caught during the last three months of public enrollment in the Heart Study, which ended in early August.
I’ve decided that I will be an Apple Watch customer as long as that product exists. That means I’m also going to be an iPhone customer for life as well. So heck yeah, I’m getting a new iPhone XS when the upgrade program kicks in. And a new iPad Pro.
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But most importantly, I’m also upgrading to an Apple Watch Series 4 as soon as it becomes available.
I guess you can say I am now an Apple fanboy of circumstance — and of necessity. But I am incredibly thankful this product exists and we now have the technology to detect and correct these kinds of conditions in people. Apple’s leadership in early diagnosis is commendable and is a shining example to the rest of the health wearables industry.
Thank you, Apple. I owe you my life. And I guess we are going to be friends for a very, very long time.
Don’t expect me to stop criticising you, though. That’s what friends are for.