DnvrFox

Some of you may have been following my palpitations experiences in the traiing and nutrition forum.

In summary, I have been having continuous palpitations, and have sent two separate Fax's to my supposed kAISER doc fully describing them - and they were continuous, with heart rate up to 155, and a very irregular heart rhythm. Then I talked with the doc on the phone, who said she saw "nothing remarkable" in what my heart was doing!!!

So, I received two posts on BFN a couple of days ago from folks in the medical field, strongly urging me to see someone about this problem. I got in yesterday pm with another doc at the Kaiser Clinc. In about 10 minutes he had ordered an ambulance, and in short order I was headed to the hospital.

It turns out I have been having continuous atrial fibrillation for 30+ days, which sort of means that the ventricles and atria aren't comminucating too well, and the atria is totally aflutter about this whole lack of communication. One way of looking at it is that I have been operating on 1/2 a heart (my words, not the docs). The two portions of the heart are out of sync.

What sort if amazed them is that I have been doing 20 and 25 mile bike rides, with no chest complaints, shortness of breath or any other symptoms except I just have not had quite the energy level I have had, and I noticed I was getting passed a little more than usual.

The danger here is that, since the atria is not pushing the blood out properly, the blood stagnates in certain portions of the atria and can clot. If my heart starts pumping real efficiently all of a sudden, and gets in sync, then blood clots can be pushed out into my brain (meaning stroke).

So, I am on blood thinners (warfarin and heparin initially), and a beta blocker to slow down my heart. Even with marked dosages of beta blocker, my heart is still beating at 120 bpm. I will go in for an EKG next week to see, but my heart already feels better in my chest. In about 3 weeks, I will likely get a "cardioversion (sp)" where they put me to sleep and shock the heart to get it back in rhythm. If this works (about 95% initial success rate and then 50% after a year) I can go off of the warfarin.

If not, I will be on the warfarin the rest of my life, or until there is another medical miracle cure.

The night in the CCU in the hospital was absolute heck! I didn't get out of the emergency room until 9:00 pm, then had to get something to eat and get hooked up to machines, and try to settle down. I asked for, and got, a sleeping pill and took it, but it didn't help. only made me groggy today.

People come and go in and out of your room constantly, and about 1:00 pm, another patient arrived, with obvious signs of heart distress - radiating pain, pressure, etc. They contiuously worked on him with nitroglycerin and other stuff, and finally transferred him to the coronary ICU unit in the morning. I slept about 1 hour from 4-5 am.

The good news is that the ticker, besides the electrical disturbances, is in great shape. No signs of coronary artery disease or anything like tha.

I need to lose weight, and I guess this is the final motivation to do that, but that was not the prime cause. In fact, they do not know the prime cause! May be hypertension or just getting older or genetic????

Anyway, I am switching Primary Care Doctors. By chance I had the copies of the faxes we had sent to my PCP about my condition, and you could see the looks of amazement on the other MD's that nothing had been done by my primary PCP!

My release says "physical activity as tolerated" so I can't wait to get a ride in soon.

Anyway, thanks to those folks who wrote telling me to get things checked out!

Darn you work so hard ot stay in shape, eat right, don't smoke, etc., amd you get caught by something like this.

The cardiologist stated:

"Think of this as only a minor annoyance, not as a major problem!"

Amen!

Bop Bop

Welcome to the world of HMO's!!! And people wonder why patients want to sue their HMO's.

Hope you get better fast. Here's to your first ride back!!!

DnvrFox

I firmly believe that not being able to sue a HMO makes a REAL negative difference in the standard of care.

lotek 

Dnvr,

Whoa, missed all that in the T&N forum (where I haven't been in a while).
Glad you're doing ok, and that someone finally took notice of the abnormal
EKG.
Arrythmias in and of themselves are not major (when compared to say an infarction)
I would venture to say that your overall cardiac health (due to biking?) played
a major roll in this not being a major event.
Again, glad you are doing well, hang in there and you'll be climbing
passes out of denver soon enough.

Marty

DnvrFox

The major concern I have is the long-term use of the cumadin and the beta blocker. You can easily bleed to death with the blood anti coagulant if you are injured, particularly an internal head injury can be critical.

Just don't know enough yet to be sure about anything!

hlweyl

I'm not trying to be argumentative, but this statement just isn't true. There are many different heart rhythms, some dangerous, some not so. Ventricular tachycardia, 2nd and 3rd degree heart block, ventricular fibrillation, asystole are all examples of rhythms that can be lethal. That being said, I have patients that I see that have been in atrial fibrillation for 30 years and live completely normal, active lives.

Dnvr, I'm glad to see everything is working out for you and best of luck with the cardioversion. I wouldn't be too worried about being on the extra meds. I see 1000's of patients every year who are on beta blockers. Although you can have side effects to just about any med, most do not have problems with them. Maybe just a little fatigue. Feel free to PM me.

jazzy_cyclist

Hang in there, DF!

I have some small insight into what you're going through. About 6-7 years ago, I was doing a lot of cardio stuff, in particular a lot on the stair climber. I felt good, but once in a while I got some palpitations where I got that "flutter" going. It probably wasn't a big deal, but the more you start thinking about how vulnerable you are and how your heart has been beating for decades... well, it just starts to cause more anxiety which in turn aggravates the situation. Although my situation was not as severe as yours, I got the same response from the medical establishment - as though I were wasting their time. In my case, because it was intermittent, it would be fine at the doctor's office, then driving home... (the broken TV syndrome). It settled down eventually after a year or two (knock on wood), but "harrowing" wasn't a strong enough word.

Good luck and try to relax!

-Jim

DnvrFox

They should have put you on a Holter monitor, to record 24 hours.

In my case, it is there constantly - I mean ALL THE TIME.

Thanks for your input.

The heart rate has slowed today.

lotek 

Hlweyl

I probably misspoke when I said arrythmias, I should have been more
specific and said Atrial arrythmias.
That said, I'm not a physician, cardiologist and I don't play one on television.
I didn't even stay at holiday in last night. . . .

Marty

hlweyl

No problem lotek. I thought you might have even meant sinus arrhythmias which are quite common. I knew you were trying to give sound advice and I hope that people venturing to forums to try and find their diagnosis take all the advice with a grain of salt.

There is no substitute for seeing a good physician.

John E

There are plenty of readily available effective nonprescription blood thinners, including garlic and aspirin.

I pay extra health insurance premiums to be on a PPO, which gives me direct access to any G.P. or specialist I choose, without some bloody gatekeeper intervening. Don't get me started on HMOs, as I detest and reject the entire paternalistic premise on which they are based.

Prosody

I'm glad you're feeling better now. I'll keep you in my thoughts. Sometimes I think the best we can hope for as we get older is that whatever parts of us break can be fixed so we can, in effect, continue our lives with the help of the pharmacalogical and surgical equivalents of baling wire and duct tape.

greywolf

I don't undersrand all the jargon Denver but I can understand that you may have a heart prob. glad you are feeling better & hope its nothing serious
all the best with it anyway .

DnvrFox

As you approach medicare, choices get markedly limited!

bnet1

Hang in there Dnvrfox. Listen to the doc (find one that will listen to YOU). It's hard to keep a good rider down.

'bent Brian

DnvrFox

Have officially changed my Doc. Took a fax to the president of Kaiser, but I got it done.

Am now on Warfarin (rat poison, literally) therapy - which means if I have a crash and have internal head bleeding I am literally done for, as the bleeding in the head will not coagulate!

Must be very careful where I ride, and wear that helmet!

Red Baron

I sincerely Wish You Well DF. Hang in there. (I know I don't have to say that, I KNOW you will!!)

hockey

Any chance you were taking VIOXX?
Hockey

DnvrFox

no

Bop Bop

Dnvr,

Two things:

1. Thank the politians for not being able to sue your HMO. The HMO put so much pressure on Congress, they just buckled. The HMO's say they can not provide care or compete if people can sue. Of course the fact they keep denying life sustaining procedures and improper care all in the name of the buck has nothing to do with it.

2. Since you are riding while using Cumidin you show have some sort of a medical ID alert on your wrist or some other very visible place. If you should require emergency medical care and can not respond to the EMT's questions, you will be long gone before they figure out why they can not stop the bleeding. Without a blood test, which they will not be able to do on the road there is no other way for them to know your on Cumidin!!! Even if you have to make one up or pin a tag to your bike riding outfit you should not be riding without it.

DnvrFox

I now carry a Medical Alert card in my wallet, which I have with me at all times, even riding. If the cardioversion does not work, and I need to remain on Cumidin, I have the information to get a formal MedicAlert bracelet and will implement that procedure. The cardioversion is scheduled in 3 weeks or so.

Thanks for the reminder.

I HAVE gotten a couple of nice bike rides in, and many long walks.

Today -

2.5 mile walk,

Also, did an hour at the gym - bike, elliptical and treadmill.

Bop Bop

Fox,

You are more than welcome.

Hope things work well for you and you get off Cumidin ASAP. Do not forget about the monthly Cumidin Level Monitoring Blood Tests. They are very important, especially in the being to establish the correct levels.

DnvrFox

Kaiser does have a whole "Anti-coagulation" service monitored by pharmacists, which calls me regularly, scheduling appropriate blood tests and adjusting my cumadin dosage.

crosswater

Then I talked with the doc on the phone, who said she saw "nothing remarkable" in what my heart was doing!!!

That's why they call it practicing medicine.

So, I am on blood thinners (warfarin and heparin initially), and a beta blocker to slow down my heart. Even with marked dosages of beta blocker, my heart is still beating at 120 bpm. I will go in for an EKG next week to see, but my heart already feels better in my chest. In about 3 weeks, I will likely get a "cardioversion (sp)" where they put me to sleep and shock the heart to get it back in rhythm.

If this works (about 95% initial success rate and then 50% after a year) I can go off of the warfarin.

Ha! Your doctors are blowing large puffs of smoke up your posterior about the year. As for the rat poison, you can use other treatments to stop the arrhythmia. None of them are risk free. There is the RF ablation (they run a catheter up your femoral artery(vein?) and burn the electrical connections in the atrium.) There is also other anti arrhythmic medications that if you read the warnings will scare you into rhythm.

If not, I will be on the warfarin the rest of my life, or until there is another medical miracle cure.

There are other meds for thinning the blood that are not as dangerous as warfarin. It nearly killed my father-in-law. He started bleeding on the brain. He only lost a few months out of his life.

The good news is that the ticker, besides the electrical disturbances, is in great shape. No signs of coronary artery disease or anything like tha(t).

It's the riding.

I need to lose weight, and I guess this is the final motivation to do that, but that was not the prime cause. In fact, they do not know the prime cause! May be hypertension or just getting older or genetic????

I go back to the practicing theory.

My release says "physical activity as tolerated" so I can't wait to get a ride in soon.

Do be careful about crashes. I got off the rat poison after three months of a class three anti arrythic med. I had the ablation and the beta blockers. All the beta bolcker did was make me tired. The anti arrhythmic (arrhythmetic - who knows) med is scary in its own right. Thirty percent of the people cannot tolerate it.

Darn you work so hard ot stay in shape, eat right, don't smoke, etc., amd you get caught by something like this.

Stress and alcohol did it to me. Quit the alcohol and still had the problem. Ended up retiring to relieve the stress.

The cardiologist stated:

"Think of this as only a minor annoyance, not as a major problem!"

That's because it's not him with the problem.

Bop Bop

As a member of the "Heart Med" club for some 15 years I know what you guys are going through. My problem is not the heart itself but my pressure, which is causing everything to go crazy.

I'm currently on 3 meds as previously stated and have started to notice something. On the days I ride for at least an 1 1/2 hours my pressure drops. Without riding and taking my meds, my pressure at it's best is around 130/90. When I ride and take my meds before I ride, my pressure some two hours or more after the ride is around 115/70. Big difference!!!

I think I'm going to start tracking it so I can talk to the cardiologist about it during my next visit.

Has anyone else noticed this type of drop?