Wednesday 29th May 2024,
Bird On The Wire

Using the Four Steps


Last week, I had the opportunity to once again use these four steps for managing my fear. I was not thrilled to be in this situation, but I was enormously comforted to have a plan of action ready to help me combat my fears.

I found out several years ago that I have an irregular heartbeat known as atrial fibrillation, which, if not treated, can result in a stroke because the uneven beating can cause the blood to pool and form a clot.

How did I find out I had this condition? Well, the weird thing is that I couldn’t tell I had it and only found out when I was lying on the table in the treatment room, ready to begin a colonoscopy. The anesthesiologist  had just started the drip when the doctor said, “I can’t go through with this!”

My breathing stopped. I lifted up my head – “Say what?”

“Your heartbeat isn’t settling down.” She sounded so worried. “And I don’t want to take any chances.”

“But I drank all that disgusting stuff, and spent all of yesterday on the toilet!” I wailed, then stopped abruptly. “What do you think is wrong with my heart?”

“I don’t know, but I’m sending you over to Emergency right now where they can give you some tests.” 

And so began my journey with afib –atrial fibrillation.

After all my tests, I found a cardiologist who performed a cardioversion on me. This is a fun little procedure where they put you out, then give an electric shock to your heart, hoping to shock it back into its normal rhythm. I had two of these done, at different times, and the second one seemed to take.  I used the four steps in each instance. 

Fast forward two years. We had moved from the San Francisco East Bay to Santa Cruz and I had found another cardiologist, whom I’d made an appointment with for a routine check-up. What he found was very distressing – my heart had once again gone into afib. I forgot to mention earlier that neither cardiologist had any idea why I had this condition. My heart was perfectly fine except for the afib.

So, the next step was to have an ablation, and when I found out that to ablate means to destroy, I was already feeling apprehensive.

What they do in an ablation is to fish a tiny camera up through your groin to find out exactly what area of the heart is causing the irregular heartbeat. Then, once they’ve isolated the problem, they send two wires up to that area, from either side of the groin, and one down through the neck, the purpose of which is to burn (or destroy) that tissue.

This is a tricky and fairly new procedure that must be done by an electrocardiologist, someone who has been trained in this particular specialty. My electrocardiologist was able to isolate the offending tissue and destroy it, but this wasn’t an easy procedure, taking a total of five hours, rather than the three that had been predicted. I’m truly grateful for the doctor’s skill and dedication that produced a good outcome for me.

So, how did I use the four steps during this time? I actually started my preparation three days before the procedure.

If you remember, the acronym for the four steps is BVMS




Surrender, Step by Step

When I sat down to prepare, I went through my breathing box exercise several times, then planned my visualizations.For the first visualization, I closed my eyes and imagined my entire experience in the hospital, from walking in to leaving. I saw myself filling out paperwork, changing into a hospital gown, and lying on the gurney, Then I visualized the nurse setting up the IV, the doctor talking to me about what he was going to do, and the orderlies rolling me into the procedure room. I imagined the room to be cold and full of stainless steel machines. I saw the doctors and nurses bustling around me. Then the anesthesiologist had me count backwards from ten, and I was out!

The other visualization I prepared was one about what I would do after the procedure. I imagined myself home in my warm bed, with my husband by my side. This is the visualization I practiced when I  arrived at the hospital.

One of my mantras just gave voice to my visualization. I said, “By tomorrow afternoon I’ll be at home in my own bed.” My other mantra helped me to relax and have faith that everything would go well. It went like this: “Dr. Chow is an expert in his field and has performed this procedure many times in his career.”

Surrendering step by step is a little more difficult to do than the other steps because it requires that you be fully present for each individual procedure you are going through. It means surrendering to the process instead of white-knuckling your way through it. It requires that you not worry about what comes next, but just be fully there for whatever is going on right at that moment.

Surrendering takes some effort and concentration, but it works. Let me give you an example. I had to stay in the hospital overnight after the ablation so that the doctor could monitor my heart. At 2 a.m. I was awakened by a nurse who wanted to draw some blood. What a perfect time for a blood test! Anyway, at that point I had so many needles stuck in my right arm that I felt like a pincushion. (Because of my breast cancer, I can’t take any needles in my left arm). So, this poor nurse looks at my right arm and says,”I don’t know where I can draw blood.” When she realized there was no real estate remaining on my arm, she began exploring my hand. I hate to have blood drawn from the veins on my hand – it just hurts too much (I wouldn’t make a good drug addict). The nurse kept looking and fretting. Finally, I pointed to a fairly big vein in my hand that she hadn’t noticed. “This is a pretty good one,” I told her as I surrendered to the process of the blood draw. I relaxed into it, and it wasn’t bad.

I have one final thing to say about my experience, and that is that I am married to a wonderful man! He has always been there for me and was with me through the ablation, as well. It is a blessing to have him by my side, but if I didn’t have him, these four steps would be all the more important, because they give me a sense of empowerment. I hope they will do the same for you.

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