I need to share

Hi everyone,

As I mentioned earlier in 'My Afib has Changed', a few weeks ago I started getting tachycardia, or 'flutter', leaving me very winded and weak. Until then, I rarely took my beta blocker and managed my heart pretty well with magnesium. These new symptoms were not manageable with large amounts of mag, or very well managed by the beta blocker I currently have, which is Coreg. (I took Metroprolol in the past). I had a stress test and echocardiogam on July 26th. The nurse practitioner overseeing the stress test listened to my new symptoms story, consulted with the doc, and prescribed the lowest does of Digoxin, 125 mcg daily. This was given me because beta blockers bring my BP down too much which is fairly normal to begin with. (Forgive me, I know I'm repeating my story a bit here). Digoxin calms the heart rate without lowering BP.

I saw the cardiologist today to go over the recent tests. They were all fine, no blockages, etc.. And he approved my heart health for a Sept 8th knee replacement. But he was able to hear me when I told him I haven't felt good AT ALL the past few weeks. And yes, the high heart rate DID cause feelings of weakness. And yes, the digoxin DOES stabilize the heart rate. I've been on digoxin for 5 days. But I still don't feel good. The doc, to his credit, said if I don't feel better near the surgery date, he supports a delay for the surgery. I think he feels my body will adjust to the digoxin and I'll regain my old sense of well-being.

I asked him about consulting with an EP. He said since I was diagnosed with a-fib in 2015, my disease is long standing and the treatments EP's do like cardioversion and ablations don't offer as much benefit as they would to a fresher/younger case of afib. And they have risks. And said they often have to be repeated. He said my treatment is aimed at rate control and anticoagulant pills. But he offered to arrange a referral if I still wanted a consultation.

I understood what he said but I'm back home and not feeling good and stubbornly think I ought to! My afib seems to be adrenal-ly caused, so beta blockers would be great if they didn't lower my BP. (I wonder if an extended release low dose of Metroprolol would be worth another try). I did ask the doc if there were other drugs besides digoxin I could take, and he said there aren't any others that lower heart rate without lowering BP.

I plan to give Vanlith's trio of magnesiums a try. I want to give my heart whatever would help it feel stronger and steadier.

Caligal:

It's hard to understand why you don't go ahead and consult with an EP since your Cardiologist's case management isn't working for you anymore. What is the downside of doing that?

As often mentioned here, first by Carey I believe, is that Cardiologists are the plumbers for the heart and EP's are the electricians. It sounds like you have primarily an elecrical problem.

Judging from your name you probably live in CA. Dr. Natale practices in both La Jolla and Thousand Oaks, neither too hard to get to from anywhere else in CA.

For peace of mind, get an opinion from an experienced EP then decide for yourself what to do.

Afib doesn't go away with age. The older you get and the longer you have fib and flutter the harder it may be to treat.

Have you made every change possible to eliminate any and all stimulants from your diet? Including over supplementing (mag ok), caffeine, alcohol, soy based products, food additives, flavor enhancers, etc. Until that is done an adrenergic afibber is just asking for trouble. The concept is to stay as natural as possible and not play ' Amateur Chemist' with a 300K year old, beautiful machine. Just saying, worth a try...

Good luck,

Jeff

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californiagal
I asked him about consulting with an EP. He said since I was diagnosed with a-fib in 2015, my disease is long standing and the treatments EP's do like cardioversion and ablations don't offer as much benefit as they would to a fresher/younger case of afib.

I started getting Afib in 2010 and was referred to a very respected general cardiologist. I wasted 3 years with him as he really didn't have good knowledge for treating Afib and I didn't know any better. Then I had an appointment with an EP and my treatment was changed dramatically. The difference between their approaches was night and day. I'd second the suggestion to see an EP and get another opinion.

It also isn't really accurate that an EP's treatments aren't as beneficial to patients with long-standing Afib. The success of treatments like ablation depend on the EP who does it--skill and experience are the primary predictors of success and there are many EPs doing ablations who do not have the requisite skill and experience.

Cali-gal. Please see an EP. I probably live near you and can suggest EPs to avoid at Cedars-Sinai if you pm me. My local EP wants me on Digoxin but I had ask Carey. His reasoning convinced me not to take it which I confirmed with my retired pharmacist husband. I’m on cardizem which lowers my BP to 70/50 or my lowest 54/46 which gets me sick.

I’m a huge fan of Tenormin/atenolol. I loved the drug plus it has a calming effect. However you have to slowly wean off if you stop. I wish I can be in Tenormin now. But cardizem converts my flutter so I’m m sticking with it for a bit.

Thanks for your comments to my post, GGHeld. I agree it's likely time to get a second consultation, especially from an EP. I'm in communication with Kelley, Dr. Natale's Nurse Practitioner. (Living in the Los Angeles area, this is lucky for seeing Dr. N). I must wait until next year when I change back from an HMO to a PPO...
It's comforting to have a community of afibbers to bounce things off on...
CG

Jeff, I stay away from all the stimulants I can think of, and lately have cut back my supplements (except Mag) to almost nil. You're right. It's hard to play master chemist with our bodies. Fun to try, but not easy and often not smart. I appreciate your input.

Nice to hear your going to give that trio of Mag. a try CalGal
In my little world the best drug to stabilize my heart rate before + after my ablation until that Mag. trio changed everything for me was BISOPROLOL. It helped me change a 100 plus resting heart rate down to the 50-60ish range in about 90 min. + keep it there for 24 hours or more. I only used it when needed which was not often maybe a 3-4 times a year like a PIP for a not too frequent lone AFIB but wow that really worked like nothing else + i have been in the Hosp. previous for both Afib + Tach. with nothing they gave me coming close to reducing my heart like this stuff and for so little of the drug itself...in other words for a standard 5mg pill i would only need a speck of that or about 1/10 of that pill to do the job. It was amazing + did not give me any side effects because the amount was so small + i was not taking it everyday also so just my 2 cents.
Hopefully you will not need it or any other drug if those 3x Mag. work well on you like they have done beyond wonders for me.

GL



Edited 1 time(s). Last edit at 08/03/2022 06:02PM by vanlith.

Have you been in AFIB since 2015? Surely if yes, your Cardiologist should have referred you to an EP?

There are consequences of staying in AF for long periods if the rate or rhythm control isn't adequate.
I tried every drug and every supplement over my very long journey (25+ years) with this condition. In and out of hospitals, then deciding to manage it at home, but not very successfully.
In the end, the only thing that really helped was an Ablation (x2) I'm probably not out of the woods yet, but oh so much better.
I keep waiting for it to rear its ugly head again, and that's because I let it go on for so long. My original cardiologist just didn't get it.

Talk to a good EP, and keep using this wonderful forum as a resource. Over the years, when I was having a particularly bad episode, this was my go-to for adding some calm and common sense. Middle of the night, early morning, anytime, it's always at hand.

Daisy,
Thanks to you, too, for your comments. Who wants to waste time not getting care that's effective.... Your comments will spur me to be proactive. I also appreciate your message challenging my doctor's comment that EP's aren't helpful to folks with long standing afib. I'm looking toward consulting w/ Dr.Natale once I get back on a PPO.

Just a comment that one's kidneys strips salts from what we ingest and discards them into the urine fluid. All the magnesium compounds, which is all they are, are salts. If you strip away the salts, what's left? And it's the same for the three magnesium variations being mentioned in the conversation above. Magnesium citrate, widely and cheaply had at any decent druggist, is as good as any. Just beware that it can act as a laxative.

I have an afibber cousin who has also been a quadriplegic for over 40 years. He lives on disability so wondered if he could substitute epsom salt for the more expensive dimagnesium malate he takes. He asked me to test it for him since my bowel tolerance and the daily quantity of magnesium I take is so large.

Here is what I wrote him:

MgSO4 molar mass 120.366
Mg++ molar mass 24.304
% Elemental Mg++ = 24.304/120.366 = 20.2%

by comparison, the magnesium malate I use is 20.0%

I weighed 1 tsp of each powder, got 5.3-5.5 g/tsp on the MgSO4 Epsom salt and 5.8g/tsp on the malate. So 1.07 to 1.11 g/tsp for the Epsom salt & 1.60 g/tsp for the malate, so not much different. I substituted 1 tsp Epsom salt for 1 tsp malate yesterday and 2 tsp Epsom salt for 2 tsp malate today. No negative impact noticed.

Here is a review article on magnesium absorption Intestinal Absorption and Factors Influencing Bioavailability of Magnesium-An Update Basically hard to measure bioavailability and not many good studies.

My experience is that any magnesium works for me. Doesn't mean that different forms may impact people differently. The different salts may also have an impact. While I've rarely taken the taurate form, I have and do take a couple of grams of taurine powder daily with my mag. Also looked at using magnesium transdermally (on the skin). Interestingly at this http://www.enzymestuff.com/epsomsalts.htm]site[/url] created by the autism spectrum community, they wanted to use the MgSO4 Epsom salt specifically for the sulphate. [web.archive.org]

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GeorgeN


My experience is that any magnesium works for me. Doesn't mean that different forms may impact people differently. The different salts may also have an impact. While I've rarely taken the taurate form, I have and do take a couple of grams of taurine powder daily with my mag. Also looked at using magnesium transdermally (on the skin). Interestingly at this site created by the autism spectrum community, they wanted to use the MgSO4 Epsom salt specifically for the sulphate. [web.archive.org]

when I clicked on the link it didn't work so I responded and found the full link- posting again in case anyone else wants to use it.. epsom salt and salt sprays are used routinely in autism probably because guts are often ravaged for those on the spectrum. thanks for the link George. I need to re-think this for someone ....

[web.archive.org]