New to this Forum

Hello All-

I was directed here from Skipping Hearts. On Sept. 30th I was walking around downtown when my heart started to race. I live in a small town and walked over to the police dept. (fire dept. was out on a call) and told them I need medical assistance.

I was in a-fib. Admitted to the telemetry unit of the local hospital. I received the following in the ER and then later on the floor:
3g Mag. Sulfate
2g Postassium, both via IV. They gave me oral Postassium in the ER, which I took.
Cardizem in my IV
Dogoxin in my IV about twice, once in ER and once on the floor.
Lovonox, subq three times, q 12 hrs.
Lopressor, both in IV and then later on 12.5 orally.

Hospitalist figured it was my electrolytes playing up...
Had an echocardiogram while in A-fib it was done as a STAT order.
Converted a few hours later that night. Saw an EP, but he figured I'd convert chemically first (and he was right!)

I was discharged the following morning on 25mg. Lopressor and 81 mg. aspirin. I'm to follow up with my regular doc next week.

I have a very strenuous job as a grocery clerk and have been under tremendous emotional stress the past few months as well: job loss, nearly losing my apartment, lost cash flow, car stopped running, death in family...all since July.

At any rate, no one every spoke to me about how to avoid electrolyte depletion again. I don't want to be caught in the cycle of meds/ablation...I've been poking around this forum and am glad to see all the postings on K and Mag.

Any advice for this scared newbie? My heart is still somewhat irritated; lots of PVC's and trouble sleeping at night due to anxiety about this whole episode.

I'm in the U.S., where our broken health care system places more emphasis on profit/reimbursement than on the health of its people. I say this because I'm a low-income person on the county insurance, so I'm a bit skeptical that influenced the course of my treatment.

The nurse processed my discharge since the hospitalist wasn't available.

Welcome, but at the same time sorry that you have had to experience your first frightening episode of atrial fibrillation!! There is a great deal you can learn from the many posters on this board and by reading our AFIB Resources section and Conference Room Proceedings.

Stress (physical or emotional) is definitely a huge factor in triggering an episode. You may wish to begin by reading the frequently asked questions which you can find at [www.afibbers.org]

Hans

On further thought.

I can't really find fault with the treatment you received at the hospital. I am not a fan of digoxin and would never recommend taking it orally on a long-term basis. However, it does serve to lower the heart rate during an afib episode although there is no evidence that it aids in the conversion to normal sinus rhythm. I am somewhat impressed that the doctors picked up on your electrolyte depletion and took steps to correct it. Now you need to make sure that you do not run low again. For advice on doing that see The Strategy [www.afibbers.org] and [www.afibbers.org]. Since you episode was during the day and likely due to stress you may wish to consider getting a prescription for Toprol XL (time-release metoprolol) on a continuous basis if you continue to have episodes. NOTE: The official guidelines for the management of atrial fibrillation do not recommend medication on a continuous basis after a first episode.

Hans

Welcome Kitty. Sorry you have need to visit us ... but I wish you welcome and happing reading here...lots to keep you busy. You'll learn that continuing to use both magnesium and potassium are going to make a huge difference in helping your heart settle down and it's impressive that you received that assistance at your local ER... as often electrolytes are not part of the protocols.

We are all here to help guide you and answer questions once you have begun to read the many reports referenced that should be very helpful.

I'm very sorry about your stress load and the circumstances, but glad you recognize the impact it has on one's health. Most importantly, as mentioned, stress depletes magnesium and then numerous other things downstream from that don't function well either so supplementing with the magnesium form of the amino acid chelate... called magnesium glycinate will offer you the best formulation to start replacing the magnesium lost from stress.

Take your time and don't feel pressured to learn everything at once... we've accumulated a lot of really helpful information and it can be overwhelming. Just let us know when you have questions.

Best to you,
Jackie

HI Jackie-

I'll never forget; the ER nurse drew lab work right away, and the hospitalist walked in. Before even introducing himself to me, he said "Your electrolytes are very bad. You will be getting Potassium and Mag. in your IV" then he introduced himself to me. =)
I am very fortunate that the local hospital is a designated cardiac receiving center. I had no idea until I was discharged. Talk about luck of the draw!

So nice to meet everyone...I look forward to learning a lot.

Hello Hans:

Thank you for your input! I'm finding a lot of valuable resources on this site.
I'm presently on 25mg Lopressor; hoping to be able to taper off ASAP.

Welcome Kittymama,

We all know and empathize with this initial discovery period and the kind of anxiety Your first visit to an ER for AFIB can bring. You definitely found the right place and you are very fortunate to have done so this quickly in the AFIB journey ... which gives you a better chance of getting that genie back in the bottle before it becomes too comfortable and familiar in causing such mischief.

Jackie and Hans already gave you the blueprint and requisite links to absorb and follow religiously. In light of the added stress component you might do well to include L-Theanine as well. Find a good brand like Jarrow, Source Natural and quite a few others that offer the registered firm called 'Sun-Theanine' and look for caps or tablets of 200mg dosing. You can start with two a day in divided doses (not both at once unless there is extreme stress) and can build up to three 200mg capsules a day taking one roughly every 8 hours with the last one before bed as it can help with sleep as well.

L Theanine is a special amino acid found in green tea and that helps counter the extra jaggy energy from caffeine such that green tea conveys a smoother calmer energy than say a strong cup if coffee.

Which reminds me, you avoid caffeine and alcohol going forward. At least until you have all this well under control and full electrolyte repletion as demonstrated by Exatest. Actually, you are best off just swearing off caffeine and more than one to two glasses of wine entirely if you really want to help minimize the odds of a repeat visit to the ER.

I too am impressed the ER gave 3grams of Mag Sulfate and 2 grams of K on your first visit. We are starting to see more and more of these reports where the word about magnesium and potassium repletion is getting through to the front lines of the ER.

Is it possible that you got a copy of your labs done in the ER ? It's always a good idea to request copies if all your records from such visits going forward .. If, hopefully not, there are any more? I'm curious what your serum levels of magnesium and potassium were that alerted the Hospitalist to do a stat order for the IV mag & K??

Best wishes,
Shannon

HI Shannon-
I requested copies of my labs and reports yesterday. I wish I could afford Exatest; I'm on the county insurance plan and it doesn't cover much. Exatest would give me a much more accurate picture of my electrolytes.

I don't know my exact numbers from the ER, but I did hear "She's hypocalemic"(sp?) more than once, so I knew then that my K was way off. The hospitalist introduced himself by saying "Your electrolytes are really bad...we will hang potassium and magnesium right away. This could be dangerious." He then told me his name and his credentials (double-boarded in cardiology and internal medicine). Not bad for my little town.

The hospital is also a designated cardiac receiving center; as they used to say on MASH "best care anywhere"

Fortunately, I don't drink alcohol, coffee (it would give me PVC's) and I don't smoke, so there are less habits to give up
I used to train for marathons and half-marathons (last race seven years ago), so that influenced me to keep my system clean.

Just received my K Gluconate and Mag. glycinate yesterday, so am looking forward to starting those...slowly.

I just remembered a snippet of conversationi from the ER. They were getting ready to hang the K and the Mag, and I was worried that such a rush of those would freak out my heart and expressed that to the nurse. She, being an ER nurse, didn't mince words "your heart is freaking out now from lack of electrolytes. You need this stuff in now." I also had to take two tablets of Potassium Chloride.

If I can just get the hang of this Beta-blocker, things will feel a lot better. It's giving me palps and is making me tired. Hoping to swtich to one that will retain my "exercise capacity".

Hi Kittymama,

Are you the same lady that used to go on the Health Sciences Institute forum several years ago?

No, I am not.