It's Official

yes, i am well aware :lol: but i am in complete agreement with you on the issue.

mixed reasons. i've just tried typing this out about 4 times and can't word it right. it's for my own damn future. but also, in reality i have no self esteem and can't stand the thought of others calling me a quitter behind my back. i know, that just buried the needle on the 'wrong-reasons-to-be-in-grad-school-meter' but i do have my own reasons, which are way too complex to describe. well, i could describe them but i don't want that kind of attention. my own reasons are enough to keep me here.

in my usage of language, to call it a terminal degree is to say that's the highest degree you can get in the field. the highest level of accomplishment, however, stretches far beyond the degree. as far as i'm concerned it's the number of lives i can positively impact that puts the value on the degree.

 

Fair enough.

Thanks for the discussion.

 

Daniel, there are a variety of pacemakers. (Hah. That's an awesome bit of understatement. Sorry, just congratulating myself.)

Many of them have rate responsiveness -- they can adjust their programmed paced rate based upon patient activity. They use sensors, the pre-programmed range of heart rates, the pace of acceleration and deceleration, etc to decide what is going on and how to vary the parameters that are programmed in (like how fast is the maximum you're allowed to beat per minute, or how slow you're allowed to go).

I concur with the other docs who have chimed in this thread -- this is something that is VERY fixable and should NOT ruin your quality of life (although it can be a pain to be sure).

 

The most common cause is fibrosis of the node -- just replacement of the area by scar, essentially. What causes that? You've got me. Also, it can be caused by disease of the artery going to the S-A node, or by a laundry list of other causes (scleroderma, amyloidosis, hemochromatosis, congenital, peridcarditis, tumors, rheumatic fever, Chagas' disease, hypothryoidism, meds, hypothermia ... blah blah blah blah blah!) Coronary disease may cause it too but that's more controversial. More than you wanted to know! Personally I think that more of it is due to coronary disease than we think, but I have no evidence to back that thought up.

 

That is precisely what higher education institutions market and would like you to believe. There are far more people out there with degrees in low paying jobs than you might believe. Anyone, ANYONE, can get an undergrad degree in SOMETHING such that it has become a diluted commodity. Even the class moron can get degrees in communication (my personal favorite lolololo], general business, or even *gasp* pop culture....

problem is, too many people rely upon a degree to tell them they are smart and capable as opposed themselves. we ve been brought up to be docile, humble, submissive sheep who shy away from conflict, and look to others for approval, esteem, and confidence. when you re not part of the gang, you re a foreign threat that produces conflict, and we all know how conflict is seen...

the bottom line is this...

if you can somehow help someone make money, that will carry more weight than any piece of paper.

the only reason you had a string of low paying jobs is because of you, not some piece of paper...

 

Yes, that's a very informative article, Evan, thanks. They say that it's becoming known as sinus nodal dysfunction. That there are two categories, intrinsic and extrinsic and it's extrinsic where medications are attributed to the condition. It sounds as if it's a condition brought on by other problems. Intrinsic being attributable to conditions such as hyptertension, congenital heart disease and surgical trauma. One of those conditions that are difficult to diagnose and cause is unclear. I don't pretend to understand all of what they're saying in the article but it makes me want to research it further. I don't know if it would help you, daniel, but I'm glad that it's treatable.

 

Yeah, no kidding... the average 'stiff' you mentioned also isn't looking to be a brain surgeon. i think you've been seriously sheltered out there in North Dakota... Plenty of people out there making far more than brain surgeons with far less education... if that's your benchmark anyway...

 

It sounds like "as others have said" that this is all fixable. Do as much reading as you can on the issues so you can give challenging questions to your doctors. The good part is your heart is healthy. The conduction system is your problem... fixable!.. just like a good engine with bad sparkplugs "Sinus Node" and bad spark plug wires "conduction pathway through the heart".

I don't know about the diet part for the sinus, but the SSS is easily fixable with a pacemaker, the A-fib you could technically live with too if you had to, but as Evan said should be able to be fixed with oblation. Many people live with it just fine, but if I remember right, it will knock out about 30% of your cardiac output while your in it and that makes you feel crappy.

Also if your in A-fibb, and its brand new for you "as in one day or so", they like to try and cardiovert you with electric shock and put you on meds to prevent it from coming back. Stay away from lots of caffine, stress or other stimulants, they can make you more susceptible.

The reason they like to convert you is because A. You obviously feel better "its not life threatening", but if your in it for long, then they have to put you on coumadin for several days before they will dare to correct it. The reason is because when the top part of your heart is not beating "the atrium" but only "quivering' it is not opening and contracting like it normally would be and so blood is not filling and emptying properly. You may already know this, but the concern is that while it is not beating it tends to fill with little coagulated particles... which basically means "clots that cling to the walls".

If they convert you before dissolving those with coumadin first they could endanger you for little clotted blood particles going throughout the body and cause blockages or strokes. They would be released into the arteries and as the arteries continue thier journey towards the capillary bed they serve they get tinier and smaller. As soon as the arteries diminish in size to the point of the diameter of the clot, then you have an embolus and a blockage. The tissue that that artery was serving then would be without its blood supply.

Many people only get more concerned with details... this is why many doctors don't volunteer too many details unless asked.
Others do much better with information... it soothes the unfounded fears of the unknown.
I trust you are someone who does better with details, so I offer a few, I hope its for good and not for bad!

This obviouly can sound very scary, but its very very common and easily treated with medicines before cardioversion is accomplished.
Worse case senario is that they could not oblate "rare" and medicines would not work "also rare" and then you would simply live with it and just take it easy. Kinda like the horsepower of your engine would have 30% power removed. You still function normally, just not with as much top end abilities.

This kind of stuff sounds extremely alarming when its happening to us, but its all treatable and very common.

Daniel, when its finally your time to go, it shouldn't be due to these issues. Just don't be afraid to let your doctors do what they need to do and you will be just fine. Also don't be afraid to let them be aggressive in thier treatment if you have the insurance to support it. There are always risks from the moment you get your first IV in the hospital, but you go there to get better, not worse. So you should get better.

I hope something I have said brings comfort....We will look forward to hearing from you when you return feeling better!

 

Daniel:

I swear, as I was reading this thread over the past few days, I thought everyone was talking about me. I too have had occurances of fast heart beat as well as everyday multiple occurances of missing heart beats. Once, I went to the ER because my heart would just not convert back to normal sinus rhythm. They injected (slowly) a drug meant to slow it down but after about 3 hours it just converted on its own anyway. Darn scary. Hasn't done it that long ever since. But they put me on Digoxin (.25 once daily). I have absolutely no clue whether that has helped or not. But I do still get these attacks. But the length of them average from one minute to 15 minutes. I get all sweaty as if I am going into shock. I just find a place to sit and wait it out.

One thing I have recently thought of as a theory is these things occur when my face is facing downward. And if I feel any sign of an occurance I immediately look up. Haven't come to any conclusions yet. This thinking actually may be really dumb. But it is the only thing I have thought of that occurs when I do get these things.

I dont know if I am on a beta blocker or not (per Evans article he shared) but I am on Lotrel (5/20mg). Heck, maybe that isn't helping either. I do take asprin (325mg).

Boy, I feel I am re-running the same info back at you Daniel. I too was concerned and got the same feedback from my doctor. But when your out and about (like the other day at the court house when I was delivering papers that my house was paid for) and it hits you out of the blue, it really is frustrating. All I could do is just sit on a bench out in a hallway and feel myself get all sweaty. About 15 minutes into it all of a sudden normal sinus converted back automagically. Thank gawd.

So, your not alone guy. I appreciate all the comments shared here too by the learned folks in Medicine. The human body is one of those things which I think does take a Phd to understand. There sure is alot to know. There are good doctors and bad ones just like there are good car mechanics and bad ones. But when you find a good one stick with them.

Oh, and ironically as well.........

I too am one of those who have learned via the school of experience. I was lucky to have gotten a great career early in my life in broadcast engineering. All it took was to get a 1st Class Commercial Radiotelephone license. But I had no college education. Went on to another career in Computer Science and worked in IT departments of fortune 500 companies. As well as the Medical College of Wisconsin in their IT department as well.

I always was a self learner. Enjoyed teaching myself as I felt I got more out of it than being spoon fed. I felt I truly understood concepts better. It also forced me to think too. Which, ultimately is what that piece of paper is supposed to prove. Sadly, I agree, it doesn't always attain that goal.

Enough from me. Thanks all for your contributions to this thread. It has been truly meaningful.

Cheers

 

Make sure you tell your Doc you are still having these episodes, he will prob want to bump up your Dig a bit. And I would bet it is helping you... thats a very common medicine for A-fib... but it takes a while to zero in the exact dose needed.

 

Daniel is sounds like you share some of the A-fibb issues that Three60guy has but in addition you have SSS. The SSS I'm thinking is actually more dangerous... without an intial firing from the Sinus, the a fibb prob wouldn't happen anyway and the escape firing would happen lower at the junction "rate of 40 - 60" or even the ventricles "rate of 20 - 40". In other words.... when you get the SSS under control, then you may be on better ground.

Talk you your doc, but it may not be wise to go hiking till you get the SSS under control... I'm sure Even can chime in here and help more.

I'm also guessing that Three60guy interpreted his A-fibb as missed beats, but they are not the same as SSS. SSS is actually Missed beats whereas the sinus just doesn't fire... and that can be a bit scary and something to not take lightly, But A-fib is where the beat has a pattern known as "irregularly irregular".... that rhythm feels like you are missing beats because they are not regular. When in a-fibb carrying that pattern, you may have two or three quick beats together with a very short period of rest where there are no beats, yet you may be averaging 70 beats per minute which is ok for pumping blood and good perfusion of blood to the brain.
Those periods of pause are rarely longer than a sec or two.

But with SSS you can have much longer pauses!.. If you go for 5 seconds without blood pumping, you lose conciousness and could passout and bang your head on a rock or even fall off a cliff!... and hopefully with SSS, your beating it kicks back before the lack of oxygen starts a cascade of events that cannot be reversed shy of cpr.

Once you get your pacer, you can rest easy about the SSS. The a-fibb is just a nuisance since in a worst case senario you just loose about 30% output.

Evan, If I am misleading on any points, please feel free to correct me.

 

If it was me, I'd go on the hike because being physical, out in the clean air, is more beneficial than sitting it out. One of the issues that was brought up in that article that Evan referred me to suggested lack of oxygenation. A lot of people don't know this but along with not drinking enough water, a lot of Americans don't get enough oxygen. Paying attention to your breath is so important in day to day living and taking really deep, full breaths throughout the day oxygenates the deep tissues. There's a small book called The Science of Breath that describes the entire process but, basically, when you inhale, the lungs deposit oxygen in to the blood stream which carries it to the rest of the body. When it comes back to the lungs from its long, circuitous route, it is loaded with the impurities that it's picked up a long the way. It picks up impurities and drops off oxygen. When it gets back to the lungs, it drops off the impurities and picks up fresh oxygen. When you exhale, you are expelling the impurities. Full, complete breaths nourish you and full, complete exhales purify you. Most Americans don't breath deeply enough and exhale fully enough so the blood is forced to go back in to the body impurity-laden, oxygen-poor. Getting out in to the fresh air, exericising and breathing may not cure you but it will improve your health.

http://www.shout.net/~jmh/clinic/science_of_breath/