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It's Official

Discussion in 'Fred's House of Pancakes' started by daniel, Dec 28, 2005.

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  1. daniel

    daniel Cat Lovers Against the Bomb

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    Well, after years of my saying there was something wrong with my heart, the cardiologist finally agrees. Up til now they just told me, "It's nothing, don't worry about it." But last week they had me wear a heart monitor, and yesterday they put me on a treadmill and the doc said I have sick sinus syndrome. The sinus is a clump of nerves that act as the heart's internal pacemaker, and mine's going bonkers. Tachycardia-brachycardia. I get episodes of atrial fibrillation interspersed with moments when the heart stops beating. They have no idea what causes it, and there's no cure for it. Any medicine that slows down the fibrillation will agravate the brachycardia, and vice versa. I may be a candidate for a pacemaker, but they'd still have to use powerful drugs to control the a-fib. I've tried those before and they're nasty. Guess I won't have to worry about the end of oil. It ain't gonna happen in my lifetime.
     
    #1 daniel, Dec 28, 2005
  2. TonyPSchaefer

    TonyPSchaefer Your Friendly Moderator
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    If you get the pacemaker, would that make you hybrid?
     
    #2 TonyPSchaefer, Dec 28, 2005
  3. efusco

    efusco Moderator Emeritus
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    Bah, find another cardiologist....preferably and Electrophysiologist (specialist in the heart electrical activity).

    Controlling a-fib can be done in many ways. Many drugs are not that bad and have minimal side effects. Pacemakers can do what's called "overdrive pacing" which basicly takes over control of the electrical activity making a-fib a rare issue. Sometimes electrophysiologists can do a proceedure called an 'ablation' to get rid of some of the pathways leading to the a-fib. And finally there's a relatively new proceedure called a "MAZE proceedure" that is a much bigger but well tolerated surgery where incisions are made in the heart to block the electrical pathways that lead to a-fib.

    In no way is SSS a life shortening problem in the era of modern medicine, it's readily managable in 99.9% of patients and if yours was that hard to diagnose then it probably is a very mild case and thus more likely to be managable.

    Besides, if you're having a-fib that often you need to be on a blood thinner, if it isn't that often then several low side affect meds should be able to keep the rate low or help prevent its occurance while the pacer does it's job of preventing the brady dysrhythmias.
     
    #3 efusco, Dec 28, 2005
  4. DocVijay

    DocVijay Active Member

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    I agree with Evan. Find an EP and go see him/her. Also, my father just had an ablation procedure and it worked for his a-fib. There are things that can be done.
     
    #4 DocVijay, Dec 28, 2005
  5. mdmikemd

    mdmikemd Member

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    Agree with Evan...see an electro physiologist...for years my mother had heart problems that her "traditional" cardiologist couldn't figure out...went to a EP, and got things under control. Ablations used to be somewhat of a last resort, but I'm seeing a lot of patients getting it now and it's moved into the realm of routine.
     
    #5 mdmikemd, Dec 28, 2005
  6. galaxee

    galaxee mostly benevolent

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    wow, a medical advice forum! :lol: glad we have so many experts around here.

    daniel, best of luck finding the care provider and treatment that works best for you. hope you're feeling better soon.
     
    #6 galaxee, Dec 28, 2005
  7. EricGo

    EricGo New Member

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    Daniel, it is just a bad spark plug.

    No biggie. So long as the engine is in good shape, an electrician will fix you up just fine.

    Whether to take anti-coagulants is a harder question, and depends how often you go into A Fib, for how long, and what the first fix is. There will not be the million other cases of experience to fall back on, so listen to someone smart.

    If it was me, I would go for a fix that kept me off anti-coagulants, in order to keep bicycling without additional risk of serious bleeding from the drug in case of a fall.

    Take care, and good luck
     
    #7 EricGo, Dec 28, 2005
  8. tripp

    tripp Which it's a 'ybrid, ain't it?

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    See a barber before you go any further. Your humors may be out of balance. A good bleeding might cure your ills. :lol:

    Seriously though. Definintely get a couple of opinions on the matter. And keep your head up! A positive attitude can do wonders... a negative one can do the opposite.

    Take care!
     
    #8 tripp, Dec 28, 2005
  9. daniel

    daniel Cat Lovers Against the Bomb

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    Thanks for all the replies. Especially from the doctors. With my trip to the antipodes just 6 days away, nothing's going to happen before I get back. When I do, I'll ask my cardiologist to recommend an electrophysiologist, as Evan recommends.

    This stuff was just an occasional event for me until a month or two ago, and the last time I had a stress test it had never happened during exercise. Only within about the past month and a half has it become daily.

    But the cardiologist said there's no arterial blockage, and that my heart is strong and structurally sound, and that it's okay for me to go on this trip. He did insist that I take aspirin, which I began immediately, and that I not hike on any knife-edge ridges. I thought he was joking, but he was actually concerned that I could pass out and tumble down the mountain. I think the hiking will not be extreme on this trip.

    I especially appreciate your information that pacemakers can control a-fib as well as brachycardia, and that ablation is becoming mainstream.

    I trust this cardiologist. Remember, this is the first time I've seen him since I just moved here to Spokane. When he saw my King of Hearts recordings, and read my letter that I'm about to leave for my trip, he phoned me and saw me immediately, and even did the treadmill test that same day. In Fargo I had to wait a month or two for my last one (though in that case it was a Cardiolyte test, which required much more machinery.)

    Anyway, thanks everyone. (And note that I'll be gone for 5 weeks starting in early January, and might not have opportunity to access the internet.)

    Oh, say. Here's a couple other random questions for the doctors here: can dietary factors influence sick sinus syndrome? How about Zantac (which I take for a duodenitis)? Or Lipitor?

    ... Hmmm. So now I have to start worrying about the energy crisis again?
     
    #9 daniel, Dec 28, 2005
  10. Mystery Squid

    Mystery Squid Junior Member

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    Good luck Daniel, I'm sure you'll do fine... Heck, if they put a man on the moon 35 years ago, this can be taken care of! :)
     
    #10 Mystery Squid, Dec 28, 2005
  11. Jack 06

    Jack 06 New Member

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    I'm going to go out on a limb here a little, and also PM daniel. So far it's seemed OK to daniel to discuss his health publicly. I don't know if that will extend to what I'm about to say; that's why I'm PMing him.

    Is anxiety ruled out as a possible cause of what otherwise appears (and is actually experienced by you) as a heart problem?

    I ask because I had similar symptoms for a period of a few years before anxiety was diagnosed---partly by process of elimination. With me, it had to get to the point of hyperventilation---a full-blown "panic attack"---before I saw---and accepted---the light.

    If national statistics (and extrapolations) are to be believed, others who are PC members can speak to both depression and anxiety. I am no longer self-conscious about it; many others are.
     
    #11 Jack 06, Dec 28, 2005
  12. efusco

    efusco Moderator Emeritus
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    1)You're welcome.
    2)A hiker huh! There are lots of enviro-loving, out-back hiking, open-minded athestist accepting eclectic women out there in the backpacking world. Maybe you need to spend more time hanging out at REI and base-camps to meet gals!
    3)I wouldn't expect Zantac or Lipitor to be issues. If you're on any blood pressure meds, smoke or use a lot of caffine those might be factors. There's some literature that Omega 3 fatty acid supplements may have some anti-dysrhythmic activity...some of the early studies showed amazingly good evidence of benefit and my wife has terrible PVCs if she's off of her "Omegabrite". You should know that a recent study, however, showed no benefit and possibly a trend toward more dysrhythmic activity. <_< Anyway, I think there is very little risk of harm and decent potential for benefit. If you ask your cardiologist and he thinks it's OK I'd recommend starting about 1500mg Omega 3 FA daily--I like OmegaBrite brand (you can order online) b/c of high purity standards with particular attention to making sure there's no mercury. At your age that's really not an issue (mercury), but I still prefer to know they concentrate on purity. Also, it's never a bad idea to make sure your diet is good and you can get Omega 3 from multiple sources including fresh fish.
     
    #12 efusco, Dec 28, 2005
  13. galaxee

    galaxee mostly benevolent

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    evan, studies always depend on conditions. i guess i can't comment on that omega-3 study since i haven't seen it myself, but you always take a paper with a grain of salt until they've convinced you thoroughly. was it a convincing study with good controls? very glad to see non-researcher MDs keeping up with recent lit, my family practitioner back home didn't seem very 'up' on recent studies when i asked her about some things.


    and jack06, depression and anxiety are rampant here in grad school, i hear about it all the time from colleagues. it's said that antidepressants are the breakfast of graduate students. and here i am thinking i should probably get myself another prescription for them before i relapse again. but i digress.
    every time the boss wants to have a 'meeting' (aka scream at the grad student for 2 hours) my heart races and i feel faint. one of these days i'll probably hit the full blown panic attack stage. anxiety is definitely bad for you. which is why i'm looking for a new lab. although at 23 years old i haven't noticed any heart troubles, just infrequent nasty chest pains if i inhale deeply. suppose that's leading up to something though, isn't it?

    hmm. i guess all that stuff has quite an effect on the body. i think we're all trying to ignore it, many people here have very stressful jobs that may be taking more out of them than they think.
     
    #13 galaxee, Dec 28, 2005
  14. efusco

    efusco Moderator Emeritus
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    Part of the problem with the various supplements and vitamins and "natural" cures on the market is that there is no "good" research--at least as far as double-blinded cross-over large "N" studies that have been confirmed by another researcher with similar study design. Why? $$$$$ Nobody's going to get a 15 year patent on Omega 3 FA and then be able to charge $1/pill (or more) to 25% of the US population for 15 years to offset the R&D and trial costs.

    Thus, you have a huge market selling to gullible people who read lame articles with no scientific or statistical validity based upon annecdote.

    That said, the research for so many "real" drugs is so bad as to be pitied as little better and possibly worse than that of the 'supplements' market. Studies that are manufacturer sponsored are designed to give the result they want, when they don't the articles are thrown away and never submitted for publication. It's a big problem all around.

    But yea, I do what I can to keep up, it ain't easy--particularly when you practice in a field that requires a broad knowledge of all specialties and, thus, the meds used by each of those. I'm also a study design freak and am skeptical of about 99% of stuff that comes out and pretty much 100% of stuff that's drug company sponsored.

    Anyway, the Omega 3 studies are about as well done as can be expected considering the lack of 'big money' to pay for them. Matched patient populations, event monitors recording dysrhythmias, etc. I don't know if either study was blinded. There is a lot of pretty good info out there on Omega 3--There's a book my wife's been trying to get me to read called "The Omega Factor" or something like that and it discusses the research and potential for Omega 3.

    FWIW, I took Omega 3 religiously for about 2 years due to it's reported cardiac and neurologic benefits. I quit taking it about 2 months ago simply b/c I felt the evidence of long term prophylactic benefit was fairly weak (my wife says I'd think otherwise if I read the damn book) and I had not had any acute symptoms or problems I was taking it for and felt no improvement in my overall health while on it.

    My wife takes it daily and is convinced it reduces her PVCs and will have long term health benefits.
     
    #14 efusco, Dec 28, 2005
  15. JackDodge

    JackDodge Gold Member

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    To the doctors in residence here, I'm curious if you have any ideas of what causes sick sinus syndrome. Not so much what the consensus is in the medical community but what you think. I've read Dr. Dean Ornish's book on reversing heart disease and this is a completely different topic, apparently. I'm always fascinated by medical issues and one factor that always comes to mind is the contribution to health by modern lifestyle and how different it is from the lifestyles of previous eras.
     
    #15 JackDodge, Dec 28, 2005
  16. efusco

    efusco Moderator Emeritus
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    I don't know enough about the etiology to make an informed guess. As Daniel intuitively asked, medications are the most common cause of the types of sinus dysfunction, but I don't think that qualifies for the diagnosis of SSS which must be a primary problem with the SA node itself.

    For those interested this is a good article:
    http://www.emedicine.com/med/topic2132.htm
    (note: You'll probably need to register at the site to access the article, but emedicine.com is a very good medical resource--I far prefer it to webmd)
     
    #16 efusco, Dec 28, 2005
  17. galaxee

    galaxee mostly benevolent

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    and pretty much no academic lab is interested in that stuff, so the national scientific funding agencies are out as far as funding goes. any lab that does that kind of stuff is usually under contract for the money.

    it's purely self-promotion most of the time for those natural supplements. i even saw the term 'nutraceuticals' once and it made me sick to my stomach. i support much stronger regulation of these products personally, but i don't see it coming any time soon. the little label they are required to display, something about how their statements haven't been evaulated by the FDA, isn't enough. how about drug interactions and metabolic interference? some things are all right but some can be downright dangerous.

    i'll be sticking to multivitamins :)
     
    #17 galaxee, Dec 28, 2005
  18. Mystery Squid

    Mystery Squid Junior Member

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    See, this is what I can't understand. Not to derail the topic, but I've found that worthwhile discussions are frequently tangents anyway... Anyhow, what I don't understand is WHY people put themselves through that sort of BS? I USED to think grad. school and such was primarily geared towards the pursuit of knowledge, instead, it was more like 90% political bullshit, and with my personality, I, naturally, gave the appropriate authorities the finger, literally, and figuratively. My livelihood isn't worth whatever more money I MIGHT have made, which will soon be exceeded ANYWAY. Pursuit of knowledge? lol

    I HATE being medicated in any way, shape or form, and to do such as a resultant of another's actions, within the realm of higher education AT THAT, is quite honestly, stupid at best. What for? That piece of paper on the wall that makes one feel good? Sorry, don't need it. The income? lol

    Sorry for the tirade, but this one hits close to home, one of the biggest lies ever told, one of the biggest scams, is graduate school for MOST fields is a necessity for success, and for a SHORT while, I believed it. Heck, has anyone noticed that out of the top 10 individuals one Forbes 400 wealthiest Americans list, only ONE even bothered to get an undergraduate degree? lololol
     
    #18 Mystery Squid, Dec 28, 2005
  19. galaxee

    galaxee mostly benevolent

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    ok squid, you've hit it. hard. when i started i had 2 reasons.

    1. to discover things. you know, work in a lab and learn stuff noone else has seen yet.
    2. to delay getting a real job. (yeah laugh all you want, at least i'm being honest)

    now... after 18 months of being tossed around like a ship in a hurricane, i will agree that graduate school is 90% political nonsense, 9% learning to be a stubborn bastard, and 1% academic. my entire reason for being here has been obliterated.

    why am i still here? good question. i'm just the kind of person who finishes what she starts. despite the effects on my health (and my sanity...) i'm still here. because i don't want to be the one who quit. the one who couldn't cut it. now it's about competition.

    plus, moving back will cost a small fortune and i will not stay in this general area unless i have something keeping me in this place.

    thinking about transferring schools, at the moment i'm looking for a way out of this lab with the pi who stresses me out so much.

    so do i, and yet here i am studying pharmacology. i don't like drugs yet i will spend my life designing or testing them. the more i learn about the molecular mechanisms of all the things out there the less i want to do with anything stronger than ibuprofen.

    yes, it's stupid but here i am. i'm in full agreement with you on the whole topic, but once i've gotten into something i stick with it. plus, i've always been the kind of person to go as far as i possibly can, and since the phd is a terminal degree that's what i decided to shoot for.

    on the bright side, they're paying me something instead of the other way around... :rolleyes:
     
    #19 galaxee, Dec 28, 2005
  20. Mystery Squid

    Mystery Squid Junior Member

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    First off, I'm glad you didn't appear to take any real offense to my post. Blunt and to the point is my style, no sugar coating, but I'm sure you already know that. :D

    Secondly, the "I don't want to be the one to quit" part. Why? Is this for YOU or because someone ELSE might think you're a quitter if you do? Obviously, only you truly know.

    Finally, I'm slightly surprised to see you call a PhD a "terminal" degree. Seems like you're placing MORE emphasis on the actual piece of paper/committee confirmation than the theoretical ever continuing, ever evolving, lifetime of learning. The piece of paper is just that, a piece of paper, nothing more, contrary to what anyone else might say.

    The educational system in this country is seriously F'd up. Everything beyond high school needs a SERIOUS re-vamp, but of course, we all buy into it because that's the *way it is*... :angry:
     
    #20 Mystery Squid, Dec 28, 2005
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