Friday, August 24, 2007

New Conditions

Well something in addition to bowel resection. Recovery from resection is now somewhere around 33 weeks. Things are leveling out. The suggestion by my surgeon to take Citrucel each day seems to be working. I am finding a more regular time of day, and I don't have the discomfort associated with a bowel movement that I experienced in earlier weeks. Something else has attracted my attention now.

I feel fit, I've lost 56 pounds since surgery, I am walking 2 miles every day, my blood pressure has dropped to normal, and I have stopped all diabetes medication. So things should be great, essentially they are. However...

Seven years ago I was diagnosed with Premature Ventricular Contractions (PVCs) It is an electrical signal from the ventricular side of your heart that triggers a heart beat, but it is premature so the heart cancels it and then initiates a normal beat. However, the normal beat is usually quite a bit stronger than a regular beat. What a person would normally feel if they were checking their pulse is the sensation that the heart skipped a beat. Sometimes it is quite jarring, other times I feel a light fluttering sensation in my esophagus area.

About two months after surgery I had an A-fib (Atrial Fibrillation) episode where the atrial side of the heart beats very rapidly and the blood flow to your body is reduced. You become tired and simply drained of energy. A-fib attacks are often associated with stress, however they can result in a serious problem because the swirling action of the blood in the heart can create a clot that could go to your brain or down to your legs.

Prior to the A-fib attack I had an increase in the PVCs. They are not necessarily linked, but stress can be a common denominator. At least that is my take on the two problems, perhaps a cardiac physician might know, but I have not read any articles that link PVCs and A-Fibs. Anyway, I noticed an increase in the PVC episodes and called my Dr. What was confusing was I was also a little tired when the PVCs would hit. Anyway I ended up in the hospital for two days while a cardiologist straightened out the A-Fib problem. The treatment was a drug called Rythmole, within twelve hours my heart converted to a regular sinus rhythm and I was discharged. I had to take a drug, Warfarin or Cumadin for thirty days, it is a blood thinner that cuts the risk of a clot should another A-Fib attack hits.

Back home I had no more episodes of A-Fib and after thirty days discontinued the blood thinner. In addition the PVCs seem to grow more infrequent and less distinct. I was a happy camper. Then a month ago I started drinking coffee like I was addicted. A pot of coffee with my wife upon rising from sleep, if I worked out of the house a pot of coffee during the afternoon, or if I was at work I drank cup after cup of coffee during the day. Then at night another pot of coffee and to bed. In addition I was drinking diet colas during the day with lunch, dinner, or just to sip on. I did not realize the caffeine intake was so great. After several weeks of this I noticed a change in my PVCs. They seem to increase in frequency and to group.

As I became more aware of the PVC episodes I noticed that they tended to group around three times of the day, morning, mid-afternoon and night just before I went to bed. I also was eating extremely acidic food that one night had my system so upset I had a stomach ache most of the night that kept me awake until around 4 in the morning. I say this because I was overloading my system with caffeine and spicy food.

Pretty soon my PVCs were quite frequent and seem to come in waves of patterns. I would feel my pulse through my throat and could sense beat, beat, pause; beat, beat pause, sometimes it was beat, pause; beat, pause. Those didn't last to long, but they did come in strings. Sometimes these episodes would last ten or fifteen minutes, other times it seemed to go on for a couple of hours. One thing was certain PVCs were occupying a great deal of my consciousness.

Finally I called the cardiologist and he scheduled me to wear a holter monitor for 24 hours. When the technician put the monitor on me she said do you drink caffeine? Yes, a lot. This lady apparently has had episodes associated with too many stimulants. It got me thinking, so I have cut way back on coffee. Three mugs in the morning and I have stopped drinking colas or sodas with caffeine in them. The PVCs have not gone away, but they don't seem as frequent, they seem more random and not as strong.

The results of the holter monitor test was everything was fine. There were some irregularities but nothing to put me at risk. I was stunned. The night I wore the monitor I had a really strong episode and it went on for some time when I went to bed. I was sure they would find all kinds of evidence of irregularity, perhaps they did but they were not of much consequence.

Last Saturday I had a good day, very few episodes, except when I went to bed and it was mild. Sunday, some episodes, but not too bad. Monday started OK, but Monday afternoon I got into a situation where every time is stood up and walked my chest would flutter, if I sat still it was quiet. Tuesday went fairly well, except Tuesday night I was delivering a lecture and about 8:30 PM away they went and finished the lecture at 9:00 with my heart flopping like a fish. I took my rythmole pill and within ten minutes the PVCs stopped and I drove home OK.

I have been taking a 0.5 MG Xanex at night to help me sleep. It seems to calm me down and while I have some PVC episodes when I lay down they haven't been too strong and I rest well. Today I went to an appointment with a new family doctor. Our old guy retired. The clinic is very slow right now and the doctor spent 45 minutes with me. He is going to see if he can get the holter monitor report and check it out. I was so stunned by the monitor report I forgot to ask how many times an irregularity occurred. We are also going to do a blood panel because I have now lost so much weight and am exercising I want to know if I can get off the Tricor pill I take.

The panel will also check out my electrolytes, mineral levels, and thyroid just to see if there is any imbalance anyplace that could contribute to the PVCs. We are at least making some progress.

I talked to my brother-in-law this afternoon. He has a heart condition and he confirmed that he had PVCs and had very similar episodes as I did. In fact, he and my sister set out for the hospital several times just to have the episode stop while they were on the way.

I know this is long, but this is for me. If someone reads it and stays till the end fine, but I'm venting here.

Anyway, more research on PVCs on the internet has yielded me the information that PVCs are not serious, are benign issues. Yet they are conspicuous and attract your attention so you feel like maybe you are going to die. My brother-in-law has lived with PVCs for years. He now has a pace maker, more to keep his heart going as for anything. He suffered a heart attack that leaves him with a heart that has 60% capacity. The pace maker has a defib attachment and that is why it is in place. However it does also help control the PVCs and his occurrence rate has dropped. It has not quit but it is infrequent, plus he has become some what callused and just goes on.

I was relieved to have that conversation with him, it helps me put things in perspective. I shall still try to limit caffeine if not get rid of it. I will continue to exercise and I will continue to live my life, hopefully one day at a time. I'll try to get the incidence rate down and reduce my stress to also reduce frequency. I do not feel so threatened now, but it is hard to be real accepting.

In the meantime the bowel resection goes well, and I feel good. So there!

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