New Here and Overwhelmed

Hi everyone,

I'm the wife of a newly diagnosed afibber. I'm glad to have found this website and forum as a resource but it's honestly a lot to swallow all at once. My husband is 38 and has had heart palpitations and bradycardia for some years, but recently ended up in the ER for his first big afib episode. Hearing about how he's got 5x the risk of stroke is shocking for someone so young. I'm 32 and expecting our first baby in two months, and it worries me to think about something happening to her daddy.

My husband does have a stressful career and is generally a very intense personality, so I've wondered how much of his heart problem is stress-related. He is also very tall and thin, has had stage 7 baldness since his college years, bradycardia, very low libido, and in the last few years started to experience anxiety. We've checked his thyroid, done a sleep study, checked his labs, and did a holter. At the end of the month, he's supposed to see an cardiac electrophysiologist. So far, no one can really tell us WHY this is happening (and maybe science doesn't have an answer for that yet?)

Since his trip to the ER, I've taken him off all wheat and soy products (we were already vegan, so no dairy or meat either). Based on some of what I read on this website, I'm giving him taurine, magnesium, and ginger, and he is continuing to take B12 and Vit D which he's been taking for years. His doctor asked him to take a baby aspirin each day, but since we prefer to go as natural as possible, he found some research from Dr. Michael Gregor recommending the medicinal use of cumin instead of aspirin, so he's taking the equivalent amount of salicylic acid in food grade cumin that would be in a baby aspirin (he has since started bruising easily, so I assume the blood thinning properties are working.)

After we started all this, he went for about two months without having an afib episode or even one of his frequent palpitations. Before, he would generally have palpitations a few times per day, just momentarily, which would clear up with some coughing. But this week the palpitations have started coming back, and we are both nervous that he'll have another afib episode. He can definitely feel when it happens, and it scares him a lot.

Can anyone offer a word of advice or comfort? Is there something else we can be doing? Thank you in advance for reading all this.

I don't know that any of us who populate the threads here are experts, least of all me, but I would still want a full endocrinology assessment and perhaps several hours with a competent psychotherapist. Stress and anxiety go together, but it's not like it's a symbiotic or salutary arrangement to have them. Stress can be harmful if is too high a burden. The anxiety is from not achieving goals, or realizing that continuing apace will be deleterious or unsustainable over the long term. Self-knowledge is important here.

I don't know what the parameters are for an angiography, but maybe an exploratory one might help IF...IF...an MRE/CT doesn't show anything obvious. Did your husband have a MIBI stress test? I was given two over five years. Both negative in my case, but....???

How much Vit D, and is it D3? If he's indoors almost all the time, seasonally or not, he needs about 4000 to 5000 IU each day, and may not have enough to stay healthy.

Low sex drive can be stress-related, due to changing interests (sorry), worry, lack of sleep, lack of testosterone,

I'm going to return to psychotherapy once again because I have two males whom I know somewhat well, one of them myself, who like their 'me' time and who don't do well when the needs of others imposes, especially for a protracted length of time. If your husband is a 'driver', and is driven, his changing circumstances, including your condition, are starting to weigh on him (again, this is just me wondering...not diagnosing...), and he's not having a good time of it. He needs someone whom he values, whom he respects, to coach him to what must follow FROM HIM if he is to survive the stresses he's feeling. He needs to rethink what he has grown comfortable with over the years.

I'\m going to stop and let others provide some advice. I know, it's a ton going on, and a lot of it is scary and filled with uncertainty. If it turns out that he's his own worst enemy (and who hasn't come to that realization in time?), he needs to know it and to deal with it constructively.

Best wishes to both of you.

Thanks for your thoughtful reply.

Yes, he's taking 5,000 IU of D3 daily. He hasn't had an angiography, but they did an ultrasound on his heart to check the valves and structures and everything seemed to be fine except for a tad bit of regurgitation which they said was okay. He did a stress test and it was normal.

I'm curious if there is any link between testosterone and afib? That was the reason I mentioned the hair loss and low sex drive.

I wouldn't categorize him as the same type of "me time" male that you mentioned. He's actually really big on quality time and will take me everywhere with him if I let him. I am sure my pregnancy (and the fact that we are moving to a new house at the same time) is a big stressor for him. But not sure what can be done about it? He saw a health coach once for his stress levels and came back saying, "that was dumb. what a waste of time. I could have gotten all that on google." lol.

Ha! That's very reassuring and good to see...he's self-aware and not wrapped up in his career. So, maybe a full endocrinological assessment is in order, although you'd think most of that would have been done. They do know about the testosterone?

I am loath to conclude my feedback with this observation, but there IS such a thing as genetics, and maybe what we're seeing is this coming to the fore. Here, I would be at a loss.

I do hope you get some other members offering their insight for you.

Thanks, gloaming! I will check into the endocrinology aspect as you have suggested.

Feel bad for both of you going thorough this. For the anxiety, unless there is an underline medical condition, I would recommend he seek counseling, the sooner the better. While there are many cases it can be a medical cause in most cases it is not, but all testing should be done. Anxiety is the most common form of mental health issues and it is easily treated. Be selective in deciding on what therapist. For anxiety you need a therapist that is skilled in Cognitive Behavioral Therapy. Not all therapists are. Avoid a therapist that just has you talk. He needs to be given tools to work w it.

The issue w many anxiety sufferers, not sure if this applies to your spouse, is in many cases the start of the anxiety is distorted thinking. They think about something that provokes the anxiety and then it feeds into a reoccurring thought loop. The thought loop can be difficult to break. You need a therapist to work on the triggers. Anxiety is difficult to stop by yourself. As the saying goes if we could treat our own mental health issues we wouldn't need therapists. Cognitive Behavioral Therapists will give him the tools. Knowing it is easy to treat there is no reason for anxiety patients to avoid counseling.

Have you talked to him about any fears or thoughts that trigger the anxiety? I do not know if this applies. For example new child and house along w cardiac issue is a lot to handle. Is he worried that the heart affects his income which affects ability to afford a house? If this is a trigger then if possible to calm his worries you could think about obtaining, unless you have it now, disability insurance etc. Many employers offer it.

Many people find relief from meditation, yoga, or exercise. He may want to consider one of them. For mediation there is a channel on YouTube - look for the Honest Guys. They have numerous meditation videos one can use w meditating.

I think many of us on the the forum would tell you they experience some feeling of anxiety when they feel that heart rhythm change even if its transient and short lived. To have that adding to the anxiety makes things that much harder.

Good Luck - hope he fells better soon.



Edited 1 time(s). Last edit at 06/14/2023 12:49PM by JakeS.

Thank you for posting this, Jake.

I have a history of depression, OCD, and generalized anxiety disorder, so he's always been the "strong one" supporting ME while I've gotten cognitive behavioral therapy for myself. He could never quite understand my anxiety, because either he didn't have anxiety OR it was so totally subconscious that he couldn't see it in himself. I'd always ask him, "don't you ever worry about stuff? Don't you get anxious?" He would try to sympathize with me when I was in an anxious spiral, but it was always SO EASY for him to deal with stress. He's always been a high performer, the kind of guy that never gets bothered by anything. But for a long time, I suspected that one day he might reach his limits...

Three years ago, we were living overseas, he had a management position with an American organization in the Middle East. He'd been working there for six years by then, under very stressful conditions, and he had his first panic attack. It hit him hard, perhaps because it was a very sudden shift from "invincible" to "I feel like I might die at any moment." He had a lot of severe anxiety and panic for several weeks. His foster dad, who is pretty much the only person who can give him advice on managing his thought life, helped talk him down from it.

Since that point three years ago, he's been more empathetic to my own struggle with anxiety, and he's stopped seeing himself as invincible. He now knows he has limits. It scares him to think about death. He realizes he has too much stress and wants to reduce it. I think he's just at a point where he doesn't know how. I've been encouraging him to see a therapist, but he thinks they're all dumb and will just give him a teddy bear to hold onto and ask "how does that make you feel?" He's such an alpha dog, there's no way I can imagine him doing yoga or anything that looks like a woman's sport. Any tips on how you, as a guy, got to the point of embracing therapy for stress reduction? I totally agree with you that there are unhealthy mindsets driving his workaholism, but I think as his wife, I can see that more than he can right now.

Welcome, Cottagerose -
So sorry you're struggling and very glad you found the Afibber's group. There's a wealth of info, advice and personal experience history/testimonials. Just don't let it overwhelm you... because it's easy to do that.

A very important consideration is determining if you are low in intracellular magnesium. That's very common in afibbers and the good news is, repleting magnesium is relatively easy and not costly. There's a huge amount of info posted on the topic and we can all guide you to those links. Stress depletes magnesium quickly and easily and when a person develops Afib, it typically is stressful...and for some, highly, stressful. The supplemental magnesium is often relaxing, calming and helps you cope.

Here's a report listing 10 symptoms of Magnesium deficiency... Just general info... Many more reports archived here with details specifically for afibbers.
[health.clevelandclinic.org]

From our Archives... check the titles on reports at these links... (a few of many) - we can list more if you like.
[research.afibbers.org]
[research.afibbers.org]

Take your time. We are all here to help guide you.

Jackie

PS - Definitely follow Carey's very important advice added after my post.... The magnesium just helps tolerate and/or reduce stress...and may help with arrhythmia eventually but it typically doesn't work quickly.

Jackie



Edited 1 time(s). Last edit at 06/14/2023 05:55PM by Jackie.

Quote
cottagerose
His doctor asked him to take a baby aspirin each day, but since we prefer to go as natural as possible, he found some research from Dr. Michael Gregor recommending the medicinal use of cumin instead of aspirin, so he's taking the equivalent amount of salicylic acid in food grade cumin that would be in a baby aspirin (he has since started bruising easily, so I assume the blood thinning properties are working.)

Aspirin is a very old and less effective means of preventing strokes and cumin even less so. Aspirin is no longer recommended for patients with afib and hasn't been for years. I understand you want to remain as natural as possible, but it's stroke we're talking about here. Keep in mind that death is not the worst outcome from a stroke. Trust me on that; I spent 15 years in EMS and nothing scares me more than strokes. Try to imagine being unable to swallow or control your bowels. Most people really don't understand how devastating a stroke can be. Several years ago my neighbor had a stroke. He was 32. He spent a year in a rehab facility, and when he came home he had no use of his left arm, his left facial muscles were paralyzed, his speech was badly impaired, and he is now permanently disabled and unable to work.

I strongly recommend that you make an exception to the all natural lifestyle in this one case. See an electrophysiologist (EP) and allow them to prescribe a proper anticoagulant if it's deemed necessary. Given his age it's possible it isn't necessary now, but until you know his CHADS-Vasc score you have no way of knowing, and I doubt his GP does either.

Thanks for your reply on this. I was unaware that aspirin is not recommended for afib, as two different doctors have asked him to take it. Can you point me to more resources on this?

Many of us know how stressful it is to first have AF - and it still is for me when i have an episode but much much less so since i've learned more (and lots of it from others on this site )
If your husband is anti Yoga or similar techniques, perhaps he will do/try breathing techniques. Some good advise on here as well.

Quote
cottagerose
Thanks for your reply on this. I was unaware that aspirin is not recommended for afib, as two different doctors have asked him to take it. Can you point me to more resources on this?

That's the problem with doctors who aren't EPs. They haven't kept up with continuing medical education in the afib arena because it's not what they treat, and what was taught 20 years ago in med school was aspirin. That's true not only of primary care docs but even general cardiologists. There is no substitute for an EP if you have afib.

That said, did you follow my link and calculate your husband's CHADS-Vasc score? I ask because it's possible even an EP would recommend aspirin if his score is 1 or 0, which it might be given his age.

That said, yes, I'll find some more resources on this issue for you, but it's very well established medicine.



Edited 1 time(s). Last edit at 06/14/2023 11:47PM by Carey.

Thanks, Carey. Yes, I followed that link, and his score is 0. And you're right, I was scratching my head because it was his cardiologist and his GP who said to take aspirin. We do have him scheduled to see an EP in a few weeks, but I wasn't holding my breath because so far no one else has been able to do more than say, "go home, take aspirin, and hope you don't have a stroke." Actually, that's not true. He did get a prescription for Metoprolol 25mg to take as needed. I believe he wasn't given an antiarrythmia type like Flecainide, which I've been seeing discussed on the boards, because he has bradycardia and the concern was with slowing his heart down too much? I might not be understanding it correctly. He hasn't taken one yet because he hasn't had anything last more than a few moments since picking up the prescription.

But yes, your comment that GP's and cardiologists are no substitute for EP's makes them sounds like a particularly helpful kind of specialist for afib. Maybe I should have higher hopes about seeing him.

Okay, it's great that he has a CHADS score of zero! Even an EP might prescribe low-dose aspirin for that or even nothing at all. Having the metoprolol for use as needed is also good, just make sure he understands that "as needed" means if his resting heart rate is over 100 for a prolonged period (hours not days). The flecainide? Eh, at this point it sounds like he can forego that until he meets with the EP unless the episodes become frequent and prolonged.

Hi Cottage - Some of what you described reminds me of what I’ve dealt with. I was in my mid-40’s when I developed low testosterone and afib. The low-t is tricky. When I was tested, my results came back normal, but typically the lab will indicate normal if it falls within a range, regardless of age. A level of 200 may be normal for someone older, but not so much for someone relatively young. I had to question my doctor and he agreed that for my age my testosterone was low. I was treated and it improved libido and energy levels. Although I have read studies where low-t and afib may be linked, testosterone treatment did not resolve my afib. It has definitely helped me in other areas though. Given his symptoms, low-t sounds possible - worth testing anyway. Good news is between testosterone treatment and afib treatment, I live a normal life. No doubt it is scary stuff when it happens, but it all could be manageable. The right team of doctors figured it out for me, and between living a healthy lifestyle, managing stress, and figuring out any other underlying issues (low-t for me) I feel great. There are so many success stories here with afib, so don’t get too discouraged. It’s a process, but it can be figured out. Good luck!!

Thanks, Carey...this is helpful to know.

Thanks, Winfield...I will try to get him tested for testosterone. He got thyroid testing and that came back in normal ranges, but nobody has talked yet about doing further hormone testing. I think an earlier poster was suggesting seeing an endocrinologist, so your comment also makes me think that might be a good idea.

The why is ... life. When we are young, guys like your husband simply don't feel anxiety...me neither. Then we do. Part of getting a bit older. Anxiety brings heart problems...like afib. I had to modify my work. What was easy before, starting killing me with anxiety.....via afib/flutter.

Welcome to the aging process. Sorry...it happens to us all. It has different forms for each of us. Once you get comfortable with being mortal, it is all good. You will be fine.

I suggest the "waking up" app for mindful meditation. It teaches how to manage stress and all negative thinking. Not a golden bullet, but helps me. It is important that your husband get the stress and any other triggers under control. If he (you and he together) are successful, and it's not difficult if he accepts the need for it, he's going to have many years of zero problems.

Good luck. -Sven