Few stories have stuck with me in the way that Dr. Paul Kalanithi’s memoir, When Breath Becomes Air, is cemented in my mind. Kalanithi spoke eloquently about the vulnerability that exists when a doctor becomes a patient. Recently I had the honor to sit down with a local doctor turned patient to learn more about his experience with atrial fibrillation and the cardiologist that changed his life.
Dr. Gary Penner is a well-regarded doctor in southwest Washington. He spent many years as an emergency physician in the Longview area and touched thousands of lives over his decades of caring for patients in the emergency room at PeaceHealth St. John Medical Center. What his patients did not know was that Penner himself suffered from an irregular heartbeat.
Penner had learned years earlier that he had an irregular heartbeat. The anomaly had shown up in a routine cardiac rhythm strip done during his training in the 1970s. A heartbeat that is occasionally irregular is not a problem when other symptoms are not present, and for many years Penner largely ignored his irregular heartbeat. He was able to continue to live an active, symptom-free life until one afternoon after a pleasant afternoon of fishing.
“We were hiking up a hill from the river when I began to experience light headedness and shortness of breath,” shares Penner. After a visit to the cardiologist, Penner learned that he had atrial fibrillation, which is commonly known as A-fib. A-fib is a quivering or irregular heartbeat that can lead to blood clots and stroke. In other words, A-fib is a serious diagnosis that in some patients can cause debilitating symptoms.
The doctor became a patient and the tables of vulnerability were turned. In some ways Penner was relieved to have the diagnosis. “As an emergency room physician I knew that not finding something wrong doesn’t necessarily mean that nothing is wrong,” Penner explains. Fortunately Penner was in excellent hands when he was referred to Dr. Shaun Ageno, a cardiologist who specializes in electrophysiology at PeaceHealth Medical Group – Lower Columbia. Also a member of the faculty at Oregon Health & Science University, Ageno had much experience in the area of A-fib. “When I saw Dr. Penner his A-fib was causing significant detriment to his quality of life,” explains Ageno. “We discussed the various treatment options, and although many of his questions were more sophisticated, I treated him like any other patient and began with the bare bones explanation of what happens electrically in the heart.”
Ageno shared with Penner that 90-percent of A-fib is initiated in the pulmonary vein and can be alleviated by ablating the pathways in that vein. Using a minimally invasive procedure, unwanted electrical circuits that cause atrial fibrillation can be disabled by cryotherapy, or freezing. This treatment can cure 60 – 70-percent of patients with A-fib. Like any procedure, it is not without risk. “I had total confidence in Dr. Ageno,” shares Penner. “I did my own research, of course, but I made the transition from knowledgeable physician to an educated lay person.”
The most important factor is recognizing that you are experiencing an irregular heartbeat and getting to a physician. A-fib is a progressive disease. It may begin with a few episodes and be relatively benign but can turn very deadly over time. The treatment is far more likely to be successful the earlier it can be initiated.
Approximately 2.7 million Americans suffer from A-fib. It may be completely asymptomatic and only diagnosed by a physician at an annual exam or you may experience symptoms. Be sure to see a physician if you experience any of the following symptoms fatigue, dizziness, weakness, sweating, or lightheadedness during exertion.
Penner now experiences very few episodes of irregular heartbeat, and they are easily controlled by oral medication. He is indebted to Ageno for allowing him to return to his hobbies and activities. The day I met with Penner, he had just returned from a 16-hour day in Eastern Washington, picking over a ton of apples and pears with his brother. This may sound ambitious, but it is simply another day in the life of a man who lives on a ranch with over 80-acres of land.
Gary and his wife, Katie, have a half-acre vineyard on their property and have become amateur winemakers. With over 35 varietals on their own land, they also source grapes from the Yakima Valley. Using a study from Washington State University, the Penners grow maritime climate grapes and have been very successful in producing delicious red and white wines, much to the delight of friends and family. They produce over 100 gallons of wine each year but have never sold a bottle. “If we were 25 years younger we may have started a commercial vineyard,” shares Penner. “Now we just want to have fun and share our wines with others.” The Penners have donated wine to many local charity dinners and recently hosted a group of Rotarians visiting from Australia. In addition to winemaking, the Penners enjoy watching their grandchildren’s sporting events and giving back to their community in Longview.