follow up from first cardiology appointment

Hi everyone!
The appointment went very well, I think! Thanks for asking. It lasted about 45 minutes, as I had a ton of questions for her. She took the time to listen to every question and answered them very thoroughly and with drawings. She didn't get upset or aggravated with them, and made sure I didn't have anymore before I left. She told me that what I have is called lone afib. She also called the type was Atrial Fibrilation with rapid ventricular response (RVR). I had an issue with remembering to take my metropolol 3 times a day and would only take it twice a day sometimes. So she changed it to 75mg twice a day instead of the 50 mg 3 times a day. She's definitely not a pill pusher but she did talk to me about options for the future incase it did "come back." she did say that there are a few lucky ones that only have one episode their whole life. Hmmm...if I could only be so lucky! She mentioned Dijoxin as a rhythm stabilizer, and also flecainide as a pill in pocket. She said I am not in need of either one yet though. So she said we'll just stick to the metoprolol for now and the warfarin for 2 more weeks. I asked her about my heart rate getting too low from the metropolol as ive caught it in the high 40's from time to time. She said as long as my blood pressure is stable, then I am fine. If it gets lower than 45 bpm, then they'll adjust my meds again. I asked her for the results from my prior cardiac CT and I got those. She said everything looks great except that I have a dialted aortic root valve that is 3.9 to 4.1 but is nothing to worry about right now and has nothing to do with afib. She said we will check it again next may. and I was ok with that.

I had an awful anxiety episode 2 nights ago that sent me to urgent care. For some odd reason, my left arm kept falling asleep and waking up with pins and needles in my hand, and I started developing pain in my shoulder and neck area. The rest of my arm seemed very heavy. I tried to shake it off by walking around, finding something to do to get my mind off of it and nothing seemed to be working. After about an hour, I called my wife and told her what was going on and that I needed a ride to the doctor. Ofcourse my first thought was heart attack or stroke because I guess im that irrational lol. We get to the doctor, I tell the people at check in, and they don't mess around. They took my vitals right away and got me into a room and seen by the doctor within minutes. Doctor came in, had me do all kinds of motor skills test, checked me with a plastic pin for stroke. Came to the conclusion that I had a pinched nerve in my neck from bad posture. Phew! what a relief!

I feel like I am just going from one appointment to another one all the time. Yesterday was my most recent one. The doctor wanted me to do a echo stress test. Hook me up to a heart monitor and blood pressure monitor. Take some images of my heart with the ultrasound machine, then get on a treadmill to try and reach my target heart rate, and then lay back down to take some more images of my heart to see how its functioning at a higher rate. Pretty cool test, but exhausting. I didn't make my target of 165 bpm, but it was because of the metoprolol. I only got to 150, but they said that they had enough data and said that my heart was strong. I lasted on the treadmill for 14 minutes going 5 mph at an 18% incline. It was crazy!

My next appointment is this Monday for a sleep apnea test. I'm really interested in this because I hear that afib is closely linked to sleep apnea. so when I find out, ill let you guys know!

By the way, you guys have no idea how much this forum has helped me. Not only by reading everyone's post, but also just being able to put things in to words and "talking" about it relieves so much of the stress and anxiety. Thank you to all of you ladies and gentlemen that take the time to read these and respond to all the post out there. You guys are such a great help to all!

Take care,
Robert

Hi all,
Good morning! So this anxiety is still kicking my butt :/ Every little symptom that I feel, I think the worst and it is such a vicious cycle to go through. I see my cardiologist for the first time tomorrow since my Afib diagnosis on June 29th. I'm not sure if my heart goes in and out of afib, but it definitely feels jumpy all the time. I have an app called AFIB photo detector and it tells me if I am experiencing an arrhythmia at the time but I'm sure it is not very accurate at all. I still haven't been able to get the alivecor since things are still pretty tight right now. My biggest fear is...I don't even know. Of course I am scared to death of dying, scared of a heart attack, scared of going back into afib, scared of developing another arrhythmia that is more dangerous, scared of these constant palpitations that I keep having. The scariest symptom...The one where I feel like a hard thump in my heart, and then it feels like everything is going to go dark and I think that is it, im going to die now. Almost like a sense of impending doom...its just a vicious cycle that the mind keeps playing on me. How do you guys deal with the anxiety and the fears? Any suggestions?

Tomorrow, I see my cardiologist and I want to make sure that she really takes care of me. I want her to do every test possible to make sure that I am ok, but I have a feeling like she is just going to brush me off. Is there anything that I should ask her to make me have peace of mind? Certain test that I should ask her to do? I had an echocardiogram and a cardiac CT done about 2 months before my afib episode, and all the found was a dilated aortic root valve. Not sure exactly what that means. But does anybody here think that I should get those tests redone to see if they missed something the first time? Or is afib just something that happened? Sorry everyone, I have so many things and thoughts going through my head

Robert,

I would write down all of my questions on a sheet of paper so that you don't forget anything while in the office. Office visits are short - maybe 15 minutes. If possible, you could take a friend with you to help ensure that everything your cardiologist says is understood by you. It's easy to forget things. Certainly take your prior test results with you to the appointment.

AF isn't going to kill you, and it's not going to magically "morph" into some other kind of arrhythmia. The sense of impending doom is a common one. I had it myself for months before actually diagnosing AF. Yes, it's the worst part. It also gets better.

I would save my pennies and my dimes for that AliveCor. It's really a wonderful tool.

Best of luck and let us know how the office visit goes. There is a wealth of knowledge here, that's for sure.

Robert - Almost everyone, at least initially, has deep rooted fear when Afib enters their lives. I've always felt it is because it is the heart and we all associate that to a heart attack and often death. After numerous Afib events, we begin to realize that we haven't died and life does go on, we see a cardiologist who may or may not help and we begin to look for ways to cope and also reassess what we might do to help eliminate the occurrence. As I recall my own saga, I didn't start to accept and try to relax for several years once the events began to be more persistent in both frequency and duration.

I learned about magnesium almost immediately but didn't actually take enough to help significantly. That came later.
I also didn't learn about using L-theanine or GABA until much later as well. Both help tremendously in taking the edge off stress-filled days and also help when taken at the onset of an event. If you use the search feature here, you'll find numerous posts on both natural amino acids that have the calming effect of alpha wave production in the brain...without worrisome side effects. Let me know by PM if you can't find them or need help. Some people find that taking L-theanine at the onset of Afib will shorten the duration of the event.

I wouldn't go so far as to say that Afib is no big deal... it can cause heart attacks and strokes if blood viscosity is high and that's why there are posts about addressing what causes 'thick, sticky blood or hyperviscosity.'

You can read more here: [www.afibbers.org] and do a search on 'thick sticky blood' to see numerous other reports on why it's important to address hyperviscosity and be tested to learn your status of various markers of overly thick blood and inflammation.

There are many preventive natural supplements that keep blood 'thin and slippery' so when events are of longer duration, you can rest easy knowing your platelets aren't as likely to aggregate and form a clot. I did this early on in my afib saga because I could not tolerate the requisite Coumadin prescribed at the time. That alone helped me tolerate prolonged events easier and before I had my first ablation, some of them were as long as 24 - 27 hours and then 4 hours off and back into another prolonged event.

It's been my motto to say "Knowledge is power" when it comes to doing all we can to help us get through events and even reduce the frequency of the events. Some people have managed to eliminate completely or hold it down to one in a year or two. Glad you found our forum. It has a wealth of useful information... and of course, we are here to help lend support, too.

Keep posting and we'll be here to help.
Best to you,
Jackie

Robert: Since you've been diagnosed with afib I suggest it's time for you to see an Electrophysiologist, (a Cardiologist who specializes in heart electrical issues, including afib). This may particularly be applicable to you if you don't have confidence in your Cardiologist.

Sometimes continually running to the physician for more tests can produce more anxiety than comfort. Spending some time with a mental health therapist might be a good investment. We all get physical health checkups regularly and we should all get mental health checkups regularly as well.

As Jackie said, you are not the first or only one who's going through this learning to live with afib process so keep your own records of your visits and test results. As you go through this process you will be seeing several different specialists and it will save a lot of time and retesting if you have your records on a thumb drive to access whenever you are starting with another physician or specialty.Specialists frequently have a quite narrow focus only on their specialty and either ignore or miss symptoms that another physician might pick up.

Also, I found it handy to keep a personal journal of my symptoms, sleep habits, medications and supplements. You may find that just the process of having to put some of these feelings into words and recording them is an anxiety reducer in itself.


Gordon

alivcor or iphone app which is better?


Tibbar

Tibbar,

The AliveCor is a device that attaches to any smartphone, either an iPhone or Android device.

Hi, Robert.
So how did the appointment go?

/L

Hi everyone!
The appointment went very well, I think! Thanks for asking. It lasted about 45 minutes, as I had a ton of questions for her. She took the time to listen to every question and answered them very thoroughly and with drawings. She didn't get upset or aggravated with them, and made sure I didn't have anymore before I left. She told me that what I have is called lone afib. She also called the type was Atrial Fibrilation with rapid ventricular response (RVR). I had an issue with remembering to take my metropolol 3 times a day and would only take it twice a day sometimes. So she changed it to 75mg twice a day instead of the 50 mg 3 times a day. She's definitely not a pill pusher but she did talk to me about options for the future incase it did "come back." she did say that there are a few lucky ones that only have one episode their whole life. Hmmm...if I could only be so lucky! She mentioned Dijoxin as a rhythm stabilizer, and also flecainide as a pill in pocket. She said I am not in need of either one yet though. So she said we'll just stick to the metoprolol for now and the warfarin for 2 more weeks. I asked her about my heart rate getting too low from the metropolol as ive caught it in the high 40's from time to time. She said as long as my blood pressure is stable, then I am fine. If it gets lower than 45 bpm, then they'll adjust my meds again. I asked her for the results from my prior cardiac CT and I got those. She said everything looks great except that I have a dialted aortic root valve that is 3.9 to 4.1 but is nothing to worry about right now and has nothing to do with afib. She said we will check it again next may. and I was ok with that.

I had an awful anxiety episode 2 nights ago that sent me to urgent care. For some odd reason, my left arm kept falling asleep and waking up with pins and needles in my hand, and I started developing pain in my shoulder and neck area. The rest of my arm seemed very heavy. I tried to shake it off by walking around, finding something to do to get my mind off of it and nothing seemed to be working. After about an hour, I called my wife and told her what was going on and that I needed a ride to the doctor. Ofcourse my first thought was heart attack or stroke because I guess im that irrational lol. We get to the doctor, I tell the people at check in, and they don't mess around. They took my vitals right away and got me into a room and seen by the doctor within minutes. Doctor came in, had me do all kinds of motor skills test, checked me with a plastic pin for stroke. Came to the conclusion that I had a pinched nerve in my neck from bad posture. Phew! what a relief!

I feel like I am just going from one appointment to another one all the time. Yesterday was my most recent one. The doctor wanted me to do a echo stress test. Hook me up to a heart monitor and blood pressure monitor. Take some images of my heart with the ultrasound machine, then get on a treadmill to try and reach my target heart rate, and then lay back down to take some more images of my heart to see how its functioning at a higher rate. Pretty cool test, but exhausting. I didn't make my target of 165 bpm, but it was because of the metoprolol. I only got to 150, but they said that they had enough data and said that my heart was strong. I lasted on the treadmill for 14 minutes going 5 mph at an 18% incline. It was crazy!

My next appointment is this Monday for a sleep apnea test. I'm really interested in this because I hear that afib is closely linked to sleep apnea. so when I find out, ill let you guys know!

By the way, you guys have no idea how much this forum has helped me. Not only by reading everyone's post, but also just being able to put things in to words and "talking" about it relieves so much of the stress and anxiety. Thank you to all of you ladies and gentlemen that take the time to read these and respond to all the post out there. You guys are such a great help to all!

Take care,
Robert



Edited 1 time(s). Last edit at 07/30/2016 12:02PM by Robert629.

Good too hear Robert,

Overall the cardiologist sounds like a thoughtful physician and showed good patience too with a lot of questions which is not always the case. If and when the AFIB continues to progress though, you really should align with a very experienced EP and not just a cardiologist.

You are very unlikely to find an EP recommending a use of Digoxin which really has very little place in AFIB and is usually a tip off that you are dealing with a cardio who learned to use Digoxin for AFIB in medical school and hasn't caught on to the current thinking that Dig has little place as an AFIB maintenance drug and is pretty much avoided now by knowledgable EPs except in certain more acute scenarios and usually when in the hospital when they are having difficulty stabilizing and arrhythmia and will some times add in Dig for a modest period of time along with a beta blocker or Calcium channel blocker until things settle down and stabilize some.

But her having digoxin as a possible solution for you is not a great idea so keep that in the back of your mind and also seek out a well respected and experienced EP to partner with for future arrhythmia care.

Regarding you very mildly dilated aortic root, I would not lose any sleep over that at all at this point, its still much to small to be concerned with. AFIB can indeed exacerbate an aortic dilatation, though other conditions including genetic predisposition and overdoing weight lifting .. particularly with too heavy and frequent bench presses and overhead presses etc can make the condition worse.

Typically they wont get too focused on things until the size expands to 4.5 and above and in most cases, and unless other Cardio or inherited tendencies are present, they wont even focus on a surgical correction option until well over 4.7cm and usually not until around 5cm ascending aortic diameter where they actually demand a surgery. There are exceptions, but this is the typical scenario and no one would even calls what you have now an 'aortic aneurysm'. So no worries, I'm sure you cardio was saying that with your short history and degree of AFIB, that would not at all have be a likely cause of the minor aortic dilatation seen at this point. And I am sure she did not mean that AFIB is entirely unassociated with an expanding aorta.

Take care,
Shannon



Edited 1 time(s). Last edit at 07/30/2016 07:33PM by Shannon.

Robert,

That's great that your cardio spent so much time with you. But, to echo what Shannon said, you should also involve an EP. If I may hazard a guess, such an accommodating cardiologist wouldn't mind "teaming up" with an electrophysiologist. And, to be honest, that's what it takes to beat AF - teamwork.

Sounds like the AFIB with all of the Palpitations with your HR at 200 kind of caused an anxiety attack of sorts with a panicked reaction. Just relax and spend your time and energy going through the motions of treating your AFIB. Take control of the situation by educating yourself from here, and following up with your Dr's. Normally Lone-AFIB is not acutely life-threatening. I don't know exactly what all is going on with you, but with myself, I once figured out that I was more at risk of dying by driving across town 30 miles and getting killed in a car accident than having AFIB cause a serious event.

Hello,
I'm new to this forum but have had AF and AFL for 17 years, paroxysmal for 16+ when it went persistent almost two months ago. Specifically for Robert, you're not the lone ranger. When I was first diagnosed I thought I was going to stain my shorts, didn't happen. When I was told the doctors knew what it was, "a spurious electrical event," but they couldn't tell why it happened, I made the decision to get on with my life and not let it run me. When out of rhythm I have one gauge how bad it is. If I can climb a flight of stairs at my normal pace it's not that bad. If I have to stop and catch my breath it's kind of bad. If I have to sit down on the stairs it's BAD. Regarding the anxiety, remember, if you aren't on fire and aren't getting shot at, every day is a very good day. Read, read, read! Knowledge is your best weapon. Good luck!

Re: anxiety - it's possible you're not tolerating the metropolol well. My husband was put on it some years ago and kept having anxiety and panic attacks. When they took him off it, everything was fine again.