the thread of ATRIAL FIBBING

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a month or so back i went for my six monthly asthma check-up: all fine -- a bit breathless, a bit overweight, but nothing to be alarmed about… except my blood pressure was unusually (tho not wildly) high… the nurse suggested i talk to the GP

a week later i saw the GP: blood pressure now more or less normal (the first reading seems to have been an anomaly)… but did i know i had an irregular heartbeat: i did not. he sends me for an ecg there and then and calls in another, more experienced colleague -- yes, atrial fibrillation, or AF, as everyone calls it. one of the chambers of the heart -- atrial is from atrium, latin for a large open space within a building -- is not pumping properly with the rest, but kind of fluttering quite fast… doing the work, but in the wrong way

quite common, in itself quite treatable -- higher risk of strokes, underlying causes can be sinister, need to look out for heart attacks

i had been feeling a little odd recently: in particular when waking up, a bit lightheaded, a but buzzy and fluttrry, as if the blood were thrilling in my fingertips (not quite tingling, i can never quite find a better word than thrilling, tho doctors look blank when i use it) -- was this related? maybe

referred off for blood tests (next day) and echo cardiogram (appointment a month away): warned to looking out for breathlessness (asthmatic, hard to spot), chest pains travelling to arms and throat -- if these occurred, call GP or at weekends go to A&E -- and keep the warning threshold low, better safe than sorry

OK: once you're advised to look out for chest pains -- for fear of a heart attack -- you notice a LOT OF SENSATIONS IN YOUR CHEST… plus i was intermittently feeling fluttery and odd, not bad exactly but not myself

the saturday following this GP visit, i felt distintictly weird with -- i don't know to call them -- not pains, certainly not shooting pains, but mild sensations of griping in my chest, mainly to the left of my heart… talking to NHS helpline (111); they asked a lot of questions abt symptoms (mostly negative) and go to A&E -- better safe than sorry

triaged at A&E (another ECG) and then a very long wait -- clinic is largely full of young people with amateur sporting injuries… i am not seen for some hours, probably because not instantly urgent. when seen, instantly given a disprin and CLOPIDOGREL to thin blood: diifferent kinds of decoagulant

describing symptoms to a doctor whose english isn't great: making her laugh when she ask "do you feel pain anywhere?" and i say "i'm 56, i feel pain everywhere"

hooked up to a heart monitor and left: monitor beeps trills with alarm whenever irregularity of beat gets too extreme; a nurse comes to turn the alarm off. One asks me if I’m breathing — I say, “What?” as I couldn’t quite believe the question and she says, “Computer says you’re not breathing but you must be, you’re talking to me,” and went off chuckling to herself.

Doctor comes back to take blood — as clumsily and painfully as I’ve ever had blood taken. Also unsuccessfully: she had to get a nurse to do it all over again (nurse rolling eyes and muttering “doctors,” at herself and a little at me). .More waiting: the curtain is drawn back so I can watch activity on the ward and occasionally hear my name mentioned. Lots of people in a desperate state: I’m feeling a bit of a fraud or a nuisance, though no one says so. Unsure if being let home that evening (main worry: I'm cat-sitting -- who do i call to dep for me and how to sort this out logistically, the key to my neighbour's flat is in my pocket). Also phone running low.

Sent for x-ray: wheeled there on my bad by a very chill and amusing porter who asks if i like going fast and pushes the bed down an empty corridor VERY fast, x-rayed by a very camp and anxious x-ray operator w/a big red hipster beard.

Shift changes: new nurse chatty comes on and explains stuff (inc.the wait). Doctor returns: all tests are negative, but my AF is fast (I was right to come in) and she prescribes DIGOXIN. Home again -- sleep better, thx to digoxin.

GP again: he affirms that all tests are negative (meaning no sign of impending or previous heart-attack, and some underlying causes ruled out). Chest x-ray also shows nothing sinister: apparently I have a blunted right angle -- but he seemed unworried by it. takes me off DIGOXIN and onto BISOPROLOL (a beta blocker, small dose at first in case it interferes w.asthma: in the event it does not) and refers me to a cardiologist. cardiologist visit is a bit of a frustrating dud imo: he talks mostly to himself, can't open his computer to see my relevant records (he's a locum), talks abt CARDIOVERSION (which the GP had been cautious about), which will need me going onto decoagulants and seems to think I shd have a much higher does of bisoprolol… mainly he's cross with me that the echo cardiogram hasn't happened yet.

(cardioversion is an electric shock to jumpstart the delinquent atrial chamber into synching with the rest of the heart: decoags bcz blood can pool in a fibbing atrial chamber and form clots, and the jumpstart can release it = risk of stroke)

so that is where i am: the beat-blockers are working well (i was a bit insomniac for a while but it's not a routine side-effect and may well have been pre-trump anxieties); echo cardiogram is next month -- then back to a cardiologist (i hope a different one) to discuss cardioversion or other treatment. i feel myself again, am sleeping properly, off all caffeine (and past the caffeine hangovers), dieting reasonably rigorously and planning to exercise more any day now (high-intensity work-outs are contraindicated lol), drinking only red wine now and then…

plus feeling a bit sorry for myself. and bcz i can't help feeling this was a bit self-inflicted (causes are various -- sometimes never determined -- but two likely ones are caffeine and being overweight and out of condition) (plus a month's stressing over that kickstater may not have helped), a bit guilty also :(

mark s, Saturday, 12 November 2016 10:49 (five years ago) link

I wouldn't beat yourself up about the caffeine. The latest guidelines say it is unlikely to cause AF:

"Habitual caffeine ingestion has been investigated in several prospective cohort studies (Table 9), but these failed to show any significant relationship to incident AF.168 Also, heavy coffee drinking167 failed to demonstrate a significant relationship between caffeine and AF or flutter even in very high consumers (10 cups, 1000 mg/day). Overall, caffeine consumption on a habitual and regular basis does not seem to increase the incidence of AF."

Zelda Zonk, Saturday, 12 November 2016 12:00 (five years ago) link

By the way I interviewed a cardiologist who is an expert in AF the other day (I'm a medical journalist), and because both my parents have AF I asked him what I should do to maximise my odds of avoiding it. He said: control your blood pressure, control your weight, and if you have sleep apnoea get it treated.

Zelda Zonk, Saturday, 12 November 2016 12:14 (five years ago) link

Might talk to my GP about sleep apnoea -- not aware that it's a problem, tho i do get sleep paralysis now and then.

mark s, Saturday, 12 November 2016 12:28 (five years ago) link

and thanks ZZ, i started t thread to find stuff out, not (just) to talk abt myself

mark s, Saturday, 12 November 2016 12:39 (five years ago) link

good thoughts to you mark - let's hang out soon?

Bein' Sean Bean (LocalGarda), Saturday, 12 November 2016 13:00 (five years ago) link

yes! (thank you)

mark s, Saturday, 12 November 2016 13:07 (five years ago) link

good thoughts.

my father also has recently had some of those issues (faints, trips to the hospital, checks about two years ago) (there was a risk of irregular heart beat at some point too, but it was a kind of precautionary talk).

Anyway he has been lightly exercising regularly and is feeling much better, and has had to be very very disciplined about his diet (he has cut off ALL drinking)

xyzzzz__, Saturday, 12 November 2016 13:48 (five years ago) link

POINT TAKEN

mark s, Saturday, 12 November 2016 14:24 (five years ago) link

Atrial fibrilation is an area where "excessive" aerobic exercise appears to have harms. A number of cardiologists (most publically James O’Keefe) favor some moderation (1-20 mi/wk running equivalent, but not more) because of AF, hypertrophic fibrosis, and increased atherosclerosis in high intensity runners.

5 times more AF in athletes than non-athletes
19% more AF in those exercising more than 5 hr/wk

Distribution of all possible outcomes (Sanpaku), Saturday, 12 November 2016 14:41 (five years ago) link

first reaction: i don't take tips from james o'keefe!
second: no danger here of excessive aerobic exercise tbh -- once my weight is down a bit and my asthma under better control i will explore stuff that's *gently* aerobic
(maddeningly the london fields lido is closed for refurbishment for the next few months: swimming is my usual outlet, with a nice brisk walk back and forth)

thx for links :)

mark s, Saturday, 12 November 2016 14:47 (five years ago) link

I believe AF is often congenital, and many people have it all their lives and don't know it until it's diagnosed ... wondering if/whether you caused it or could have prevented it seems like a natural reaction but also a source of needless stress.

My father has been treated for AF for a long time and it seems not to have affected his quality of life very much (at 82 it's not at the top of his long list of medical problems). The blood-thinning drugs now in use seem to be much better and safer than what he was prescribed 25 years ago.

Brad C., Saturday, 12 November 2016 15:14 (five years ago) link

One nice aspect is that this is the one area of my life in which people routinely describe me as "young"! Admitttedly my GP -- who is literally 12 -- grinned a bit as he did so the first time, but it was still pleasing to hear, if unconvincing.

mark s, Saturday, 12 November 2016 15:21 (five years ago) link

woke up at 6-ish with fingers tingling* again, first time at this degree since i went onto beta blockers -- v mild symptom in itself, but it's the one everyone i've seen seems to skip over, as in "oh, i don't know if that's linked" -- ok but something must be causing it, it only started a few weeks ago

*except this isn't the right word

mark s, Thursday, 17 November 2016 10:05 (five years ago) link

consequence: tired all day, not got much work done, can't focus (this is lack of sleep but the fingers thing seems to cause that)

could maybe up my BB dose but shd probably check with a doctor first

mark s, Thursday, 17 November 2016 15:17 (five years ago) link

two weeks pass...

ok so i just came back from my ECHO CARDIOGRAM

the nurse taking the reading sad: "apart from the arrhythmia nothing to worry about here, everything heathy and being kept under control, nothing running away with itself" -- i choose to read this as GOOD NEWS! the info will go back to the cardiologist i didn't take to and he will write to my GP and it will decided if/when i go onto to CARDIOVERSION

in terms of my self-care, basically the daily dose of beta blocker are effectively keeping everything chill, maybe twice a week i feel my fingers are fizzing and thriilling a bit and up the dose a bit

i am fully off coffee for three months more or less -- that one cup i had three weeks ago really made itself felt, and as it seems a bit daft to be necking beta blockers just to undo the effect of a strong cappuccino i will no repeat the experiment

alcohol: red wine seems fine (as per medico-urban-mythological factoid re heart health); beer's effect i notice a bit more so i will probably stick to red wine; anything wildly salty (like a large packet of crisps) seems to get my heart pit-pattering (though a good long slug of water seems to calm it down)

i am sleeping excellently (absence of coffee, who knew! beta blockers may also be contrbuting): literally for the first time in my life routine fast asleeply as head hits pillow -- i am more aware than i ever was of the degree to which yr heart responds to and contributes to matters emotional (which is obviously like DUH! given every document slurched out by the romantical-industrial complex but is still a surprise to notice when you have a condition novel enough to notice variation as it happens) -- life is just a never-ending forest of feels and yr organs are right in there working at that

so yes: next task, try and lose a bit of weight over xmas so the cardiologist doesn't make more unkind comments i guess

mark s, Wednesday, 7 December 2016 16:12 (five years ago) link

oh, also: i am definitely more physically tired at the end of the day than i'm used to being -- presumably bcz my pore wee heart is not currently able to oxygenate my blood so effieicently, one chamber is pumping much more to less effect

^^^possibly also the absence of the energy-shifting effect of coffee is contributing to this feeling -- viz i am no longer waking up tired and sluggish, which was pretty routine when i was highly caffienatated

mark s, Wednesday, 7 December 2016 16:15 (five years ago) link

ps you get to hear the magnified sound of yr own heart with an echo cardiogram, and in my case a more unconvincing and indolent arrhythmic squelch it is hard to imagine :\

mark s, Thursday, 8 December 2016 10:23 (five years ago) link

one month passes...

belated update: two saturdays ago i fainted in the bathroom, banging my head quite sharply on the edge of the bath as i fell -- i spent the afternoon in A&E being checked out

conclusion: no concussion, and incident semi-unrelated to AF -- i have also suffered from VASOVAGAL SYNCOPE all my life (proneness to to faint: going through puberty i was toppling over like an automated ninepin) and apparently it has a tendency to return in middle age. it occurs bcz the body is not able to regulate blood pressure with the swift exactness it's supposed to (so e.g. it ends up in yr legs not yr head when you stand up too quick?)

probably -- this was my sister's suggestion (she also suffers from VS, plus her partner has AF) -- the beta blockers slightly exacerbate the tendency to sluggish regulation, so i shd take it seriously when i feel dizzy and not just sit down but LIE down, with legs elevated if possible…

mark s, Friday, 27 January 2017 11:47 (five years ago) link

ffs! :/

illegal economic migration (Tracer Hand), Friday, 27 January 2017 11:51 (five years ago) link

Hope you're keeping well since then, dude - a friend of mine has a proneness to proneness brought on by having a wee - this is only amusing for everyone else.

Andrew Farrell, Friday, 27 January 2017 11:55 (five years ago) link

yes i've been fine since, no recurrance, and the doctor i saw talked me through the various triggers, so forewarned is forearmed (that particular one i don't seem to be cursed with)

i was actually a lot less bothered by fainting itself -- i am kind of used to it, tho it had been several years since the last time it happened -- than the fact of the bang on the head (a dimension i somehow always till then avoided)

the worst injury i sustained as a teen was fainting on the way to a music lesson with a schoolfriend after i turned my ankle stepping carelessly off a kerb (sharp pain was my primary trigger as a kid). i came to with my face pressed onto gravel and my pal kicking in the chest to "wake me up" -- he assumed i was kidding around, i think

i brushed myself off and limped into the lesson

mark s, Friday, 27 January 2017 12:04 (five years ago) link

one month passes...

CARDIOVERSION scheduled for 20 april: an electric shock to restore proper hearth rhythm

(i need to lose a bit of weight by then, i feel)

mark s, Wednesday, 1 March 2017 14:35 (five years ago) link

rescheduled for 18 may (and above post shd read "heart rhythm", my hearth is in good working order beats-wise)

mild irritation re poor communication between hospital/consultant's office and GP: when i first get an apoointment for this procedure, former tells me i need to be on anti-coagulants for a minimum of 6-8 weeks in preparation -- i get a letter (which i know also goes to my health centre bcz i copy and post it; i imagine it also arrives at my heath centre via the shared computer link but probably doesn't actually ping onto anyone particular's desk alerting them to this request re anti-coag)

after a week or so not hearing anything i call and leave my GP -- actually the trainee GP who originally saw me -- a message to call me, which he does the following day (he's not in every day). i ask him about prescribing the anti-coagulants: he says it's probably less complicated if i talk to the cardiology department about it, which i do

they say they'll send the request through to the health centre

i hear nothing for a few more days and ring up my GP again: he says "oh that.s naughty of them, what they should do is book you into the anti-coag clinic [or similar, i forget the actual term he used], where this is dealt with" he looks for and finds the request -- says "ok, maybe i should prescribe this directly from here, i'll just check with my colleagues if that's ok" -- which he does, fairly swiftly, so that's ok, i can pick the meds up the next day

we also both now spot that the 6-8 weeks has -- in all this fiff-faff -- been fairly sharply cut into (20 april is exactly six weeks from today) so if i do need to be on them the full whack, it's already too late. he says "maybe ring up the cardiologist and re-book"

which i do, and it's fine -- but basically the only reason any of this was sorted was me being the go-between between the two offices, which i feel is not how it's meant to work (viz if my english was poor or if i didn't have my mum's scepticism abt the ability of professionals to do the common-sense bits of their jobs better than me)

(tbf my gp is lovely -- if young -- and i enjoy talking to him; and ditto the person on the phone in cardiology -- the consultant was a bit of a twerp but with luck i will be under anaesthetic during my next dealings with him)

mark s, Thursday, 9 March 2017 17:40 (five years ago) link

my mum's scepticism was abt the ability of professionals being to do the common-sense bits of their jobs better than HER: she generally thought i was also p bad at this kind of stuff)

mark s, Thursday, 9 March 2017 18:22 (five years ago) link

one month passes...

update: after a suggestion from my sister's b/f -- who has the same condition and is on the same meds -- i switched the time of day i take my beta blockers from morning to evening

as a result i am MUCH LESS TIRED during the day (in fact back to normal), bcz my tired period as a consequence of the beta blockers coincides with actually being asleep (and in fact i sleep really well)

(i was told to take them in the morning initially bcz they sometimes affect ppl w/asthma, and also some ppl feel nauseous -- my GP felt i shd be fielding these reactions during the day when i could go into the health centre and not in the middle of the night when i'd have to go into A&E -- but as i am not having either reaction it seems an unnecessary precaution) (plus also switching them to evenings is clearly working better)

mark s, Tuesday, 25 April 2017 19:47 (five years ago) link

Glad you're feeling better; I'd missed this thread til now. I can back up the evidence that mid-50s are not for the cowardly!

Supercreditor (Dr Morbius), Tuesday, 25 April 2017 20:09 (five years ago) link

switching your beta blocker to nighttime is fine -- your tiredness may be simply related to decreased exercise tolerance, a common side effect of beta-blockers (even B1 selective drugs like bisoprolol), especially in people like you with underlying pulmonary disease (asthma). as an added bonus, there is even a little bit of literature indicating a mortality benefit from nighttime vs daytime use of antihypertensives (which include beta-blockers), though the evidence is not terribly strong last i checked

the "thrill" you feel in your fingers is actually very likely due to the AF -- when the heart is in AF, the cardiac output (a measure of how well the heart pumps blood around the body, especially the sites furthest from the heart such as the fingers) is lower due to the dyssynchronous beating. do your fingers often feel cold? this also explains your recent passing out episode (blood wasn't being pumped effectively to your brain). lightheadedness is a very common symptom of AF, and it's interesting that you mention that you've had fainting spells in the past, as you've likely had paroxysmal AF for quite some time. be sure to take your bisoprolol regularly!

being put on digoxin initially is peculiar - this drug is rarely used for AF these days

honestly if half of the people in the world were as up to speed with their medical conditions as you are, we'd spend a lot less on health care. if you're looking for a good reference, UpToDate's beyond the basics series is a really good resource for patients who care to know more about their disease and have a reasonable degree of health literacy. you can check it out here: https://www.uptodate.com/contents/atrial-fibrillation-beyond-the-basics?source=see_link

k3vin k., Tuesday, 25 April 2017 20:17 (five years ago) link

cheers k3vin, that's all extremely useful :)

if anything the finger "thrill" is more like they're warmer than they ordinarily would be: it's not a numbness -- it's a bit like the way yr face sometimes feels when you're quite drunk, that you can feel it more than you should be able to (which is overdilation of capillaries maybe?)

i did used to suffer from cold fingers as a kid (not helped by living in a v cold house and having to do lots of musical instrument practice in unheated rooms) but i wouldn't especially say i do now

i also suffer from easily putting my leg to sleep by sitting on it like a kid, slightly awkward in an office when yr hobbling around trying to get the blood back into it, and everyone else in the office is younger than you

mark s, Tuesday, 25 April 2017 20:29 (five years ago) link

(which is overdilation of capillaries maybe?)

i mean the face is when yr drunk, i don't see how the fingers would be

mark s, Tuesday, 25 April 2017 20:30 (five years ago) link

after a week or so of much better response to the BBs (as taken in eve not morn) inc actually reducing my req dose to minimum suggested, a couple of days of increased fizziness and sleeplessness (necessitating, as i am on self-imposed deadline re introductory essay to my anthology, a COFFEE today, the first in maybe ten days) (i really have been good abt coffee considering the volume i've drunk in the last five decades)

cardioversion is on 18 may: everyone is saying supersafe procedure, back at work the next day etc -- even so i am trying to get the book in proper order before i go in

mark s, Friday, 5 May 2017 10:32 (five years ago) link

Best wishes for the procedure.

xyzzzz__, Friday, 5 May 2017 14:36 (five years ago) link

be supersafe, mark.

Supercreditor (Dr Morbius), Friday, 5 May 2017 14:40 (five years ago) link

cheers guys :)

mark s, Friday, 5 May 2017 14:41 (five years ago) link

All best Mark.

Timothy Gowers, famous mathematician, blogged his mathematical reasoning as to whether or not to have catheter ablation surgery for his (much later stage) AF: https://gowers.wordpress.com/2012/11/05/mathematics-meets-real-life/

mick signals, Saturday, 13 May 2017 00:31 (five years ago) link

cheers mick, that's interesting and useful

(mr gower is i am pleased to see still blogging five years later, which is also reassuring)

mark s, Saturday, 13 May 2017 10:15 (five years ago) link

My stepdad had that procedure in 2004 after an irregular heartbeat was diagnosed after he nearly died from pneumonia. He was a very heavy boozer and has cut it down since then, but still spends a lot of time in what he calls the fun-house (it's a casino!) playing blackjack, moderately boozing and having the odd cigar. He walks a few miles to the Town library to read the papers every morning. He is definitely in better shape now than he was 13 years ago, so it must have done him some good.

calzino, Saturday, 13 May 2017 11:20 (five years ago) link

"that procedure" = cardioversion or catheter ablation? (which is next on my suggested list, if the cardioversion doesn't take after a couple of tries)

there's also an ablation where they insert a balloon into yr arteries and blow it up which is apparently 👌🏽 😜 👌🏽

mark s, Saturday, 13 May 2017 12:39 (five years ago) link

meanwhile the oblique strategy i just turned up = "go to an extreme, move back to a more comfortable place" which seems on-point

mark s, Saturday, 13 May 2017 12:40 (five years ago) link

He had the cardioversion, which I think caused him a lot of angst at the time. He said it was no biggie afterwards.

calzino, Saturday, 13 May 2017 12:55 (five years ago) link

Good luck mark, hope yr up and at 'em again in no time

del esdichado (NickB), Saturday, 13 May 2017 16:06 (five years ago) link

Good luck with the oblation/ablation, me and the kitten golems will be think good thoughts for you tomorrow!

tokyo rosemary, Wednesday, 17 May 2017 15:30 (five years ago) link

thank you! i should be out again by the afternoon and able to be back at work again the following day acc.the medical profession

(tho lol to that, i am going to stay with my sister and be pampered over the weekend instead)

mark s, Wednesday, 17 May 2017 15:52 (five years ago) link

Good luck dude, thinking good thoughts.

Matt DC, Wednesday, 17 May 2017 15:55 (five years ago) link

Yeah good luck man

Le Bateau Ivre, Wednesday, 17 May 2017 16:12 (five years ago) link

PAMPER ON MY FIBBING FRIEND

illegal economic migration (Tracer Hand), Wednesday, 17 May 2017 16:26 (five years ago) link

Take care! I mean, you are doing, so just keep on with that!

Andrew Farrell, Wednesday, 17 May 2017 16:31 (five years ago) link

ok so the excellent news is that i am up from under anaesthetic, out of hospital and down in hastings being pampered by my sister and her family -- i have to do nothing strenuous for two days which is FINE BY ME :D

the more boring news >:( is that the cardioversion did not work -- they stopped and started my heart three times but like the apostle paul it three times denied me so in c.6 weeks time i have to talk to a new consultant abt the next step ("he's electrical" acc.today's cardiologist, who also told me my "heart is stubborn") (which i am not entirely astonished to discover tbf)

anyway glad to be back in one piece (i feel fine except for a routine weather headache i've had all day, not shifted by being knocked out for 60 mins or electro-jolted apparently)

mark s, Thursday, 18 May 2017 15:59 (five years ago) link

congrats on remaining alive, commiserations on having to do it all again

glad yr feeling good! what's the next step likely to be mark?

del esdichado (NickB), Thursday, 18 May 2017 16:19 (five years ago) link

(ok it's more like four months than six i guess)

mark s, Tuesday, 8 December 2020 11:33 (one year ago) link

I have Wolff-Parkinson-White syndrome and may have to have this fibbing thingy done at some point, it may go away though, and I don't feel like I've experienced any real symptoms for more than a year, and the tachycardia used to be pretty bad, so idk, maybe it went away by itself, have heard that happens. I do have one coffee first thing every morning which seems to be ok, but any caffeine at all after midday and I will not be able to sleep until maybe 4am.

Gary Sambrook eats substantial meals (Camaraderie at Arms Length), Tuesday, 8 December 2020 11:54 (one year ago) link

best wishes CaAL :)

mark s, Tuesday, 8 December 2020 13:08 (one year ago) link

two weeks pass...

this last week i have been a bit puzzled that i seem not to be dropping off to sleep easily -- eg much late-night scrolling of random wikipedia pages to no evident purpose (the somewhat arbitrary list of unsolved murders since the bog ppl to someone earlier this year, the tale of the michelin man, did you know he once sued ilxor user MOMUS)

well as i finally drop my beta blockers to one quarter what they were three weeks ago as suggested by my my arrhythmia nurses above i just realised this is the reason: i am currently on half and will soon be on one quarter my beta blockers! i assumed i would be less physically tired but wobs is a bad week to judge that perhaps. needs less sleep feels a less handy improvement at least initially and it will probably wear off before i find a way to harness it (im not actually getting younger) but it is mildly exhilarating, like that first time when i went onto the atkins diet and more or less skipped sleep for a week without blowback! (a thrill never recaptured)

in conclusion the human body is weird, don't have one if you can avoid it

mark s, Saturday, 26 December 2020 10:06 (one year ago) link

(adding: the sleeplessness predates the two whole bottles of red wine i consumed one on eve one on day so it's not that despite the rosso being a stimulant for me at least when i haven't had much in a while)

mark s, Saturday, 26 December 2020 11:56 (one year ago) link

very palpy last night, and tachy today -- resting pulse 140-ish just now? beta-blockers prob too low too soon, upping them a bit again >:(

mark s, Tuesday, 29 December 2020 12:02 (one year ago) link

(this after six months of being nicely steady, which is annoying)

mark s, Tuesday, 29 December 2020 12:02 (one year ago) link

ffs! best of luck with the beta blockers, mark

mh, Tuesday, 29 December 2020 22:04 (one year ago) link

my doctor in china put me on beta blockers then my doctor in the UK insisted I come off them. alcohol seems to lead to more palpitations than caffeine for me for some reason, I will admit the more I find out about this stuff the more I realise I know nothing, suppose most things are like that.

٩(͡๏̯͡๏)۶ (Camaraderie at Arms Length), Tuesday, 29 December 2020 22:11 (one year ago) link

i've gone back to half-dose from quarter-dose of my betas (half that is of what i was on for a year+) and wll stick at half-dose for a while i think

my pulse-rate still seems a bit up (116) but tbh i never know when a sensible time to take it is (eating always bumps it up for a while for example)

anyway i feel much better and more energetic again

mark s, Thursday, 31 December 2020 12:27 (one year ago) link

tapering seems like a good plan

Uptown Top Scamping (Noodle Vague), Thursday, 31 December 2020 12:29 (one year ago) link

four months pass...

flutter is definitely back lads >:(

i had an ECG -- a tale in itself lol -- in advance of my heart review this coming monday and they were briefly p keen to keep me in (as happened before upthread) (heartrate fast tho not as fast as it was upthread): anyway luckily they relented when (a) as always i have no other symptoms (no chestpains, no difficulty breathing) and (b) they knew i'd be talking my specialist v soon

i p much knew it was back -- i could feel it skipping around at night and i've woken up a few times w/it racing (tho everyone gets that and i've always had sleep paralysis issues) -- but i crossed my fingers and hoped self-diagnosis was inaccurate (which tbf it is). i put my beta blocker dosage up again -- not to full wack -- so i'm mildly feeling fatigue effects (a mix of beta blockers, heart flailing away needlessly, being 61 in a month's time lol)

upside: flutter is considered less severe than the fibbing of the thread's original title, so we have in a sense progessed -- during the ablation of two years back they couldn't tap out all all the misfiring spots and i suspect the ones left untreated are combining to cause the flutter. flutters are more likely spontaneously to self-correct and the cardioversion zapped it back into behaving well for at least six and i think more like nine months

my specialist insists that caffeine is not an issue (i'm back off it but every time i have a demanding editing job i will be back off the wagon)

anyway i'm a bit fed up obviously but symptomatically it is fine tbh (some tiredness, but def not as bad as two years back) and on monday i guess we will know what ways forward there are (upside: i just got my second vax yesterday so i wd be reasonably safe for further procedures if this is what they suggest, and more to the point unanxious abt them)

mark s, Saturday, 8 May 2021 09:50 (one year ago) link

(the ECG tale is that basically i had to organise it myself and i am not my own GP so this involved a *lot* of boundary-busting pestering and checking) (including being given someone's direct email -- i think by by mistake -- which i immediately exploited with vigour)

(in the end this all worked and i was lucky in the admin ppl i reached out to)

mark s, Saturday, 8 May 2021 09:53 (one year ago) link

(including being given someone's direct email -- i think by by mistake -- which i immediately exploited with vigour)

First Boris' phone number, now his email, what are they playing at at No. 10? All the best, mark!

Authoritarian Steaks (Tom D.), Saturday, 8 May 2021 09:56 (one year ago) link

Yeah, best of luck, man.

Andrew Farrell, Saturday, 8 May 2021 10:08 (one year ago) link

hope they can come up with a good treatment plan on Monday, and that you don't feel too rough after your second jab!

colette, Saturday, 8 May 2021 10:54 (one year ago) link

Best of luck, d00d!

xyzzzz__, Saturday, 8 May 2021 10:56 (one year ago) link

had my six-month review with my heart specialist (45 mins before the appointed time, #ffs dude)

his definition of fibrillation (vs flutter) is "there's a riot going on in yr hart" -- well i don't have that any more, which is a guess one step foreard, the issue now (flutter) is much more organised (=basically it sometimes just beats much too fast). his proposal going forward is One More Cardioversion this summer, to thump everything back into shape for Good This Time, plus of course toning my well-being by losing weight, regular but not too strenuous exercise and maybe fully giving up coffee :( :( :(

i mean some of those are things i shd probably do (exercise can once more become a thing now i've had the double jab)also give up personal and globally induced stress and anxiety but that was my gloomy and resigned suggestion -- he agreed that they weren't helping and also that there was nothing anyone could do about them.

he now has moved on from filing me as a music teacher to believing i am a professional songwriter who loves the beatles -- i guess this is how he remembers which one i am. but i will always be grateful for the phrase "difficult heart architecture" so this is merely a tiny and weird price to pay

also he was effusively grateful that i organised my own ECG and got it sent to him. tbh i could do with a strong coffee right now but

mark s, Monday, 10 May 2021 09:39 (one year ago) link

he now has moved on from filing me as a music teacher to believing i am a professional songwriter who loves the beatles

LOL

Are Animated Dads Getting Hotter? (Tom D.), Monday, 10 May 2021 09:51 (one year ago) link

i raised the sleep paralysis thing (viz is there any knwon connection) but as the last question in a longish consult over the phone it didn't get much discursive attention, i will ask again when i next see him face to face

apparently there is a link with sleep apnea but im p sure i don't suffer from that

mark s, Monday, 10 May 2021 09:54 (one year ago) link

a thing happening a fair amount is that i'm being woken from very-mild-peril dreams by the racing of my heart

i know this can happen to anyone -- ie is not necessarily a symptom of the condition -- but does indicate to me how much stress i'm probably processing unconsciously, and how much (if it hadn't been for the flutter as a fact) i would be saying serenely to myself that i'm neither stressed nor anxious

ie i am very good at hiding my anxiety from my conscious mind, setting it in the background somewhere -- but it is churning away still

mark s, Sunday, 16 May 2021 09:26 (one year ago) link

new cardioversion on 22 june, maybe this one will take and also keep

mark s, Wednesday, 26 May 2021 16:18 (eleven months ago) link

my dad has some afib experience following heart attack at 60. ablation, cardioversion, etc. he's read extensively about it and has also had some occasional sleep paralysis - but doesn't connect the two (I asked him) and hasn't heard of a link. doesn't mean it isn't connected in your case of course! he reckons his afib recurs mainly due to posture and the vagus nerve, an idea that medical people apparently refuse to discuss.

conrad, Wednesday, 26 May 2021 18:50 (eleven months ago) link

crossing my fingers for 22 June btw!

conrad, Wednesday, 26 May 2021 18:51 (eleven months ago) link

I have palpitations sometimes and also get sleep paralysis when I nap - never wondered about a connection but this is interesting.

Lily Dale, Wednesday, 26 May 2021 18:53 (eleven months ago) link

best of luck to you mark, hope it all goes well.

calzino, Wednesday, 26 May 2021 18:54 (eleven months ago) link

Yup, best of luck!!

xyzzzz__, Wednesday, 26 May 2021 19:43 (eleven months ago) link

four weeks pass...

update: in and out in hours, cardioversion successfully returned heart to proper sinus rhythm for the time being, everything very routine and straightforward, sorry not to report sooner but i was still quite tired yesterday and basically just looked out of the window all day lol

mark s, Thursday, 24 June 2021 10:11 (ten months ago) link

my p-waves are back baby (for the time being)

mark s, Thursday, 24 June 2021 10:12 (ten months ago) link

glad you're back in rhythm and hope you're less tired today?

colette, Thursday, 24 June 2021 10:38 (ten months ago) link

https://www.youtube.com/watch?v=8WG118J4XlU

(note trumpet playing cowboys)

koogs, Thursday, 24 June 2021 10:48 (ten months ago) link

three months pass...

so i had a phone appointment with my consultant but as they had failed to organise an ECG beforehand there was literally nothing to talk about (i also attempted to organise the ECG -- as i managed to get one last time by battling for it myself -- but this time no dice)

i expressed my irritation abt this in the appointment and got a long lecture abt we're in a pandemic and nothing is working properly but also an acknowledgment that i was basically right to be frustrated: he suggested we switch the appointment to the royal free (where he also gives clinics) since they are now opening up to face-to-face, and since i am gong to be in the building i will be able to get a walk-in ECG beforehand (the same way it used to work before COVID)

i just got my appointment date from the royal free: it's in december (fine, i'm not really in a hurry i guess) and… it's a phone appintment

mark s, Monday, 27 September 2021 11:19 (seven months ago) link

royal free's contact structure includes me being able to send emails to change appointments -- which barts does not -- so i have done this

mark s, Monday, 27 September 2021 11:21 (seven months ago) link

six months pass...

so to catch: they caught my request abt the december appointment needing to be face-to-face and changed it -- but then at the last moment the pandemic clamp came back down and it was postponed

four months later it has not been rescheduled -- tho i am copied into to a request earlier this week from one dept to another to action this (i will chase it up next week)

i also went into my health centre last week for my various routine yearly tests: blood pressure was high and everyone went scrambling, the nurse said i had to talk to a GP. well i did -- but it was a GP who i've had before and liked (very thorough and matronly) but this time she seemed scattered and flustered, a mixture of bossy and distracted, asked me questions but only half-listened, did some hurried tests which were all fine, and eventally agreed that the best thing was to up my BISOPROLOL to see if that had any effect and to check in with my actual real GP (who i never see) if it stays high.

she also quizzed me about coffee. well the consultant has always said coffee is nothing to worry about (re the atrial flutter) but maybe BP is a different matter? so i said actually it's time i took a break from caffeine and/plus also i shd maybe shd some of my extra lock-in pounds vcz they probably aren't helping.

i don;t even drink much coffee now but this has been the toughest caffeine withdrawal i've ever been through, i'm still achey (head and muscles) eight days later and have the mildly feverish hot-eyes thing -- tho i am sleeping better. (i did a lateral flow case just in case but at least it's not THAAAAAAT… )

plus it took me ages to find my BP meter, i'd put it in a dumb place and i then kind of wanted not to test it until the caffeine was out of my system, so i waited until yesterday. BP still higher than it should be -- which of course immiedately started making me anxious, like every twinge is thet start of a heart attack. a couple of years back a nurse identified that i have "white coat syndrome" with regard to this procedure -- as if the electronic hum of the BP monitor secretly stresses me and drives up my reading. she always did it with an old-school hand-pump monitor and got "better" (lower) readings. but i don;t have a hand-pump monitor plus i always find it a bit of a scuffle getting the stupid in the correct position on my arm, which is ANNOYING and probably also raises my BP lol.

anyway today my pulse was a little lower -- below 100 -- but too high still for calm and normal. the thing is, this is the first time it's been checked for at least six months and it may have been high for AGES (i'd stopped checking bcz of the white-coat thing and just assuming i had an upcoming appointment and so on). when i was talking to the GP last week i was basically feeling absolutely fine. i'm feeling a bit rough now but i think it's 2/3 caffeine withdrawal to 1/3 ramped-up anxiety.

it's a bank holiday tomorrow, i will take it easy and then call my *actual* GP (who is good but i never actually see) on tuesday. maybe she will send me into A&E like happened in sept 2019 -- i thiiiiink i am fine (“heart rate ain’t nothin but a number” per the cardiologist in the hospital i wd be in, see upthread) and i am not keen to be on a ward at all (i am double-vaxed and boosted but the boost was five months ago)

mark s, Sunday, 17 April 2022 17:39 (one month ago) link

cant have symptom w/o typos

mm typos

mark s, Sunday, 17 April 2022 17:43 (one month ago) link

i was off caffeine for a lot of last year after my last procedure (which was successful for a while then reverted)

but over xmas i had two big editing projects and i just always cave and start the day with coffee when i'm editing: the upside we all know and love, the downside is ambient headaches and sluggishness first thing, combined with mild fatigue from the beta blockers (tho i was only only a low dose of beta blockers most of last year)

a second downside -- it belatedly occurs to me -- is that i tend to dose my headaches with paracetamol (acetaminophen), not in vast doses per day but pretty regularly, and i believe long-use paracetamol is sometimes asssociated with high BP? if cutting out caffeine also means cutting out paracetamol (as it generally seems to) then that's probably a good move, tough as it always is

mark s, Sunday, 17 April 2022 18:02 (one month ago) link

(actually tbh i've stopped finding the fatigue from the beta blockers such a problem, so that's something i guess)

mark s, Sunday, 17 April 2022 18:04 (one month ago) link

Did any med tell you to cut caffeine? I've never had one do that, never found any studies to support the idea, more like this just now (usually minus the weasel disclaimer at end):

Research suggests that caffeine isn't a cause of abnormal heart rhythms or atrial fibrillation, and drinking four to five cups of tea or coffee a day shouldn't increase your risk of developing coronary heart disease either. However, the effect of caffeine will vary between people.

Drinking caffeine with atrial fibrillation - British Heart Foundationhttps://www.bhf.org.uk › ask-the-expert › af-and-caffeine


Given the stress of doing without, which might itself elevate bp or not do it any favors, I'd keep on drinking coffee, although I do better usually with far less than five cups, unless it's an all-nighter, which I rarely get paid enough to do anymore.
But yeah if you can cut back on paracetamol (acetaminophen), that would prob be better.

dow, Monday, 18 April 2022 01:19 (one month ago) link

And sodium of course, which is one sneaky ingredient.

dow, Monday, 18 April 2022 01:20 (one month ago) link

no the caffeine decision was purely mine, not a med suggestion: and my reasoning is the headaches and the sluggishness -- plus possibly the side effects of the paracetamol i take to tamp down the headaches

i know from previous experience that once i properly kick it i can cut out painkillers altogether (i also know from previous experience that i can only kick it for a few months at a time but)

mark s, Monday, 18 April 2022 09:54 (one month ago) link

sorry you've had a rough few days, mark, how are you feeling now?

my mom has AFIB (and I'm pretty sure I'm not many years before getting it myself), her doctors have told her to limit caffeine, she says she can tell the difference if she only has one cup of coffee (sometimes half a cup of regular mixed with half of decaff), rather than a few. So hopefully cutting back will help you, although if your withdrawal hasn't stopped you could taper rather than cold turkey? My worst ever headaches were when I was in uni and taught at a summer camp; I had a strong cherry Coke habit and went suddenly to no pop at all, couldn't figure out why these stupid kids were giving me a headache everyday and finally realised it was cold turkey from caffeine.

colette, Wednesday, 20 April 2022 03:52 (one month ago) link

generally fine yesterday, mildly headachy this morning (day 11) -- monday was very bad but i think that was a weather migraine sneaking in there lol (difft bit of my head)

it's not like i was even drinking very much coffee any more, there's nowhere really to taper to! tiny little cups? plus i know myself well enough to know that tapering won't work where cold turkey actually might, at least for a while

mark s, Wednesday, 20 April 2022 10:03 (one month ago) link

Another alt to cold turkey/tapering: Sometimes when I've needed to temporarily abstain, I've found that my body can be fooled or satisfied by the taste etc. of decaf--dunno if this would work long-term, though.--

dow, Wednesday, 20 April 2022 23:26 (one month ago) link

think i'm over the hump cold turkey-wise -- it definitely took longer than usual

i went in for a blood test yesterday and the nurse told me to contact her if my blood pressure remains high; i'm meant to be seeing my own GP about all of it but (bad timing) she is on holiday till first week of may. i think i probably need the dosage my BP meds (RAMIPRIL) to be raised. also i need to talk to my cardiology specialist abt my raised pulse rate (ideally without being sent to A&E in the interim, which i want to sidestep for COVID reasons if possible) (this happened pre-COVID, basically a needless stay in hospital i feel) (see upthread for the tale… )

(i don't really want to be seen by the doctor i saw a couple of weeks ago, i find her very confusing to talk to)

mark s, Thursday, 21 April 2022 10:09 (one month ago) link

two weeks pass...

just aced my blood pressure check lol yay

health centre pharmacist then describes symptoms of high blood pressure (= headaches) and of low blood pressure (= fainting when you stand up): naturally i suffer from BOTH of these most of the time

also she said “you’re still very young” — ok then, yes that's correct i am

anyway i have booked a big "where we are now" face-to-face with my GP next week to talk abt all my many ailments and how they interact and what i shd do abt them (this is partly bcz if i am moving out of london and away from this i think unsuually good health centre i am going to be gambling with the kinds of NHS uselessness that e.g. colonel poo rightfully decries -- better get the good stuff while i still have good access)

mark s, Thursday, 5 May 2022 10:46 (two weeks ago) link

nice to hear this mark.

have you done any looking yet at what's going to be available near you?

Tracer Hand, Thursday, 5 May 2022 11:56 (two weeks ago) link

not yet no :|

mark s, Thursday, 5 May 2022 12:02 (two weeks ago) link

might not be a long piece of research lol

Tracer Hand, Thursday, 5 May 2022 12:04 (two weeks ago) link

nice possibly final visit (since i’m moving out of london) with my primary GP of nearly 40 years, just to have a face-to-face to jigsaw together the implications of all my ailments: for which the answer is mainly (a) re the topic of this thrread viz my high pulse-rate get my cardiology consultant to move his ass and give me a rescheduled appointment (she thinks more ablations are pointless but says he's the one whose knowledge counts and i will likely have to change meds somewhat as BISOPROLOL is evidently not doing what it needs to

as for my asthma more exercise and lose a little weight lol. the headaches are “stress” headaches (ie who knows what causes them, maybe just the state of the world) and (she is old-school) paracetamol is fine in moderation and not implicated in blood pressure (which is now back to normal). i’m booked for a hearing check re my tinnitus and try epley exercises for my labyrinthitis. anyway she is a good wise person (actually my favourite GP at the centre even if i nearly never see her) and i will miss her

i mentioned the *other* GP i saw a few weeks ago to my sister (who was also a patient at this centre for many years) and she laughed and said "she always made me feel i was being told off" -- which, well, true, me too, but i guess i kind of feel i deserve to be told off so it doesn't really register

mark s, Tuesday, 10 May 2022 15:57 (one week ago) link

maybe stress headaches in part from getting more writing-editing gigs, also re health and considerations of moving from London---maybe try this very basic form of meditation I read about, which is sitting for 20 minutes not thinking about much: I tried sitting on bench by front door of library after hours on a short day, mostly sheltered from the evening sun, but with a glow around the frame, just the occasional passing car, although I did sneak peeks at my travel clock, will try to do better about that ("trying" all this keeps some tension in there but I've only started these breaks).
My tinnitus long ago became part of the environment, and occasionally I think I hear crickets. Having doctor remove ear wax helped (don't try it yourself, though there are kits). Easy on the headphones for a while after that.

dow, Tuesday, 10 May 2022 17:32 (one week ago) link


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