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I am really honored to be joined with Tom Buffelano today, and Tom is a patient who's experienced atrial atrial fibrillation, and he's gonna tell us a little bit about his journey. Uh, Tom, thank you so much for joining us. You're welcome, thanks Phil for having me. Um, could you start by telling us a little bit about your journey to being diagnosed with atrial fibrillation? What were the first signs? What was that experience like? Right, so, um, So, a couple of years ago now, um, I had been experiencing some irregular heartbeats, um, while I was exercising. I was, um, uh, I'm an endurance exerciser, athlete, um, cycling and running. And, um, there were certain times during, uh, during the workouts where I would either have an irregular heartbeat or my heart rate would, would go up significantly. Um, and then I started noticing it in, in sort of stressful situations, um. Like bumpy plane rides and, and, and, and those types of things. Um, and by the way, my family history is that, that, uh, my two older brothers and my mother, um, all have afib. So Runs in the family, I guess you'd say. Um. So, in the middle of 11 night I woke up, um, I was actually visiting my mother, um. Woke up in the middle of the night and my heart was just beating irregularly. It was, you know, and it, and it didn't stop. Um, previously it had. You know, it had been temporary and, and this time it just didn't stop. So, um, I went to the emergency room and they, you know, they immediately diagnosed me with AFib. Um, while I was at the hospital, they, uh, recommended that we do a, a cardioversion, um, which they did, which I think lasted, put me in sinus rhythm for all of about a month. Um, so it, it, it didn't, uh, it didn't cure the issue. So, you know, so that from there, You know, I went back to my cardiologist and um was diagnosed with Afib and, and a flutter as, as well. So, just, you know, irregular heartbeats. Um. You know, the The diagnosis was, to me was, was a little bit scary because I had been, you know, pretty active person my whole life. And now I was gonna have to sort of change my lifestyle, um, to a certain extent in order to, to deal with, with Afib. And it was, and it was symptomatic. So I'd, I'd, I'd feel there were times when I'd go into AFib and I would feel it, and there were times when, um, I would, I would stay up all night, um, waiting for it to dissipate. Um, so it really, you know, over the course of time, it, it, um, You know, it was, it was something that I definitely, uh, affected my, you know, my day to day, um, lifestyle. Um, when your healthcare team explains that having Afib increases the risk of stroke. What went through your mind? How, how did you process that information? Well, you know, it's one of those things where, again, I look at my, my two older siblings and my mother and um You know, they're all on anticoagulants, um, and I asked them about it just to see if, if it was something that they, that they felt. Um, was, you know, was, was always in the back of their mind, um, which they did, uh, and, you know, for me, I'm, I'm somebody who, who likes to really understand, probably more in depth about. Things like You know, medical conditions, then, you know, then I probably should because it, it brings with it a lot of, uh, uh, anxiety as well. Um, but, you know, the risk of stroke, um, was, is something that, that is always concerning to me. Um, so, you have to sort of make sure that you're, you know, you're reducing. Any um factors that may lead to, um, may lead to stroke if You know, if that's, if that's something that uh that you face every day. And how has living with Afib impacted your day to day life? What are some of the practical or emotional challenges that you've had to navigate? So, so, um, exercise is something I've had to mitigate, um. Which is, you know, which is always, uh, You know, something that I, again, I've, I've been exercising as an endurance athlete for a good portion of my life. So, so moderating that is, is one thing. Um, you know, taking anticoagulants, um, every day is, you know, you have to remind yourself, take it with food, uh, take it at the same time every day, making sure that, uh, You know, that, that, that you're keeping up with your um You know, with your regimen. Um, you know, uh, you know, certain foods, you know, certain foods, you can eat, certain foods, processed foods, things like that, you know, keep your, your, you know, trying to keep more at a healthy weight, um, keeping your, you know, your BP down, um, You know, you're going for checkups, getting blood work done. Um, I mean, all, all of the, you know. A lot of people I know don't. Think twice about maybe going to the doctor and, and looking at the results and going over your, your, your different test results with your doctor and, and kind of thinking through what that means for your, you know, for your, your long-term uh health. But I mean, these are things that you have to think about every single day and you have to make sure that you're You know, you're, you're on top of, of everything. All your medical, all your, your, you know, all your dietary, um, you know, exercising to a degree that, you know, doesn't trigger afib cause in, in my case, I think, uh, exercise might have been a trigger. Um, you know, reducing, uh, you know, not smoking alcohol in a very, very extremely limited way. Um, so yeah, it does, it, it affects every choice that you make and every decision that you make, um, every single day. One of the key challenges in managing AFib is balancing the prevention of blood clots against the risk of bleeding. Could you share from your perspective on what it's like to live with this balance every day? Right, so basically, The way that I, you know, when you, when you're taking, um, Uh, anticoagulants. You Tend to bleed At times from different things like shaving. Or, uh, if I lean over, um, And try and do some, you know, something, some activity on my nose will start to bleed. Um, I, I get nosebleeds quite often. Um, so I have to think, I have to think about what my day looks like and the risk of, of bleeding. So if I'm gonna, if I'm gonna go to a, a meeting or have to do something where I need to shave, I shave the night before because I need to make sure that If I cut myself, I stopped bleeding. Within enough time to go to an interview or go to a conference. You know, with nosebleeds, I, I always carry, uh, tissues or, um, you know, there, there's some, some bleed, it's called bleed stop, um. Uh, um, you know, sort of synthetic, uh, uh, absorption things that you can put in your nose. So, You know, Every single day. I have to sort of think about what, you know, what are my risks of, of bleeding, um, and how to manage them in advance. So it's just, it's always. Something that I, I have to kind of think ahead about. And, and to take another step back, I don't like, I, I used to go out and ride my bike outside. I, if I were to fall. Um, That's something that wouldn't be good cause you could suffer internal bleeding. You know, if you're in a car accident, um, you know, you could bleed out. I mean, there's a, there, there's a lot of things that you sort of have to think about, um, When you're on anticoagulants that if they happen to you, um, it could be. Really, uh, you know, you could put yourself in a really bad situation. In, in this education we've been looking at the evidence behind an emerging generation of new therapies which may have the potential to, Prevent clots but reduce that risk of bleeding. As, as a patient. What would a new treatment option that could lower the bleeding risk, sometimes that severe bleeding risk that you've just mentioned mean for your quality of life and peace of mind? Well, it would, it would certainly.