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Heart Palpitations Forum >> Symptoms and other concerns >> Monitor results RLR
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Message started by rosekay on Jan 6^th, 2012, 2:35pm

Title: Monitor results RLR
Post by rosekay on Jan 6^th, 2012, 2:35pm

I've had years of episodes of skipped beats, which built up and lasted several weeks before slowly fading away for months at a time. Now, I've had it going on for about 6 months with no respite. I feel them any time in the day and night, but seem to notice them more at night when my heart seems to stop, thump, shiver......and I get more and more scared. Saw my doctor today, but of course nothing happened when she was listening! Typical! Pulse around 90. BP low (always is). She's sending me for thyroid tests again, and an ECG and says she thinks I should see a cardiologist - all of which is good. What should I ask the cardio in order to really be reassured? I should be used to all this, but I can't stop the worry when it's bad.... :-[

Title: Re: They are back....so is the worry
Post by rosekay on Jan 11^th, 2012, 4:26am

Had my ecg yesterday. Heart was hopping and skipping all over the place all day until the 20 or so seconds on the machine, when it behaved perfectly. Typical. >:( Was so hoping something would be picked up. Still being referred to cardio as I'm reporting that they are worse now than before. I just want it to stop!

Title: Re: They are back....so is the worry
Post by Chris on Jan 11^th, 2012, 10:59am

Hi Rosekay,

I'm sure RLR will be along to offer some input, but I was exactly the same when I went for an ECG.

Many years ago when I first started having these beats they absolutely terrified me. One day my heart was skipping all day long and I felt awful, felt sick, incredibly panicky and went to A&E.

Lo and behold, the 30 seconds I spent on the ECG, no skips!!

I don't think this is a coincidence - it just so happens that it doesn't skip when we actually want it to! That's a strong suggestion that a huge part of these missed beats is down to our anxiety.

Hope that reassures you somewhat ;)

Title: Re: They are back....so is the worry
Post by RLR on Jan 11^th, 2012, 4:02pm

Hello Rosekay,

Indeed, the absence of symptoms on presentation to your doctor is quite revealing and should actually be cause for you to relax. Symptoms that are functional in nature, in other words, symptoms which are not caused by underlying organic disease, are highly impressionable to a change in conditions. When you are at home or out of direct reach of safety and reassurance, your fears will increase physiological change as a consequence of stress upon the central nervous system. Consequently, your concerns become even greater as these changes produce increased blood pressure, palpitations and other associated features.

True medical disease cannot hide from detection once you arrive to your doctor. Problems of an underlying organic cause simply cannot revert back, but rather steadily progress regardless of the setting you are in and whether or not you are under medical evaluation. You must come to the point in your life where you can admit to yourself that your notions and perceptions are entirely inaccurate and faulty. What you believe to be symptoms of something that can harm you is nothing more than your body responding to the irrational fear and apprehension you have developed regarding such a premise.

You're fine, Rosekay. There is nothing regarding these symptoms that can harm you, so you need to take a breath and relax. You're also spending entirely too much time ruminating about all the possible circumstances which can arise and it's entirely unproductive. You have to realize that you can't just remain so vigilant as if it's necessary to preempt some type of catastrophe. The moments of your life should be spent enjoying all that it has to offer, not the overwhelming fear that something hidden and undetected is going to suddenly rob you of it.

You suffer from a considerable degree of anxiety which can produce changes in your physiology. You need to recognize this and begin to focus on ways to lower your anxiety levels. If you need to seek a professional who is trained and experienced in such matters, then by all means make efforts to do so. The problem here is not physical and no matter how many times you rush to your doctor, the tests will turn up negative. Only you believe the problem to be physical in nature. It's not.

You're going to be just fine.

Best regards,

Rutheford Rane, MD (ret.)

Title: Re: They are back....so is the worry
Post by rosekay on Jan 17^th, 2012, 2:33pm

Well, RLR, you've put into words what has been sort of lurking at the back of my mind. I totally understand what you say about the palpitations easing when in a "safe" setting.... I have actually noticed myself that they begin to ease even after making an appointment with my doctor, it's like giving myself permission to relax, in a way. They had been bad for so long, then during the couple of days after phoning the surgery I actually noticed improvement. I sort of feel like I've passed the burden of them onto someone else and I can let go.
I really don't panic about them all the time, don't even think about them until they kick off for some reason, then the cycle begins. It's such a very unpleasant feeling. I don't want to waste my life worrying about it all, and I am really making an effort now not to panic. I can feel the skips at the moment but I think I can ignore them - maybe I feel safe because I'm talking to you! Thank you for your real good sense, and I hope I can continue to progress - I will certainly try my best! Thank you again - you help such a lot!

Title: Re: They are back....so is the worry
Post by rosekay on Feb 28^th, 2012, 2:26pm

Having a 7 day monitor in a couple of weeks to hopefully catch the flippin' things and so be able to hopefully do something to stop them! Will wait and see what happens....

Title: Re: They are back....so is the worry
Post by RLR on Feb 28^th, 2012, 3:52pm

Please feel free to post the Holter monitor results and I'll be glad to discuss them with you.

You're going to be fine, Rosekay.

Best regards,

Rutheford Rane, MD (ret.)

Title: Re: They are back....so is the worry
Post by rosekay on Mar 3^rd, 2012, 1:18pm

Oh, thanks, RLR - will let you know what happens, though my appointment with the specialist isn't till July- another sign not to panic I guess! Many thanks for all your help and advice :)

Title: Re: They are back....so is the worry
Post by RLR on Mar 3^rd, 2012, 4:44pm

Well, you nee to relax. The tests will turn out negative but if nothing else, serve to provide reassurance.

Best regards,

Rutheford Rane, MD (ret.)

Title: Re: They are back....so is the worry
Post by rosekay on Mar 9^th, 2012, 9:06am

I think I get extra worried because no one has ever felt or recorded myheart when it is really bad.... and some days really are bad. If I can catch a bad episode on the monitor and show them what I worry about, and then have it cleared, I would be much easier about it - i hope. We will see! Thanks very much x

Title: Re: They are back....so is the worry
Post by rosekay on Mar 15^th, 2012, 1:00am

halfway through my monitor week, and just started to have lots of bumps and thumps for it to pick up. Not as bad as a couple of weeks ago when it was really violent for a day and a half - one gap between beats then was so long I honestly thought it wasn't going to pick up again. So hoping this is going to help to alleviate symptoms!

Title: Re: They are back....so is the worry
Post by rosekay on Mar 15^th, 2012, 1:03am

ps - this monitor things comes adrift quite a bit and sets off a ding-dong alarm sound - very awkward when you are in a class of kids and it is very quiet!! ::)

Title: Re: They are back....so is the worry
Post by rosekay on Mar 20^th, 2012, 1:00am

Am quite upset today. Took the monitor back to the hospital yesterday morning, as I said it did catch some bumps and thumps etc over the week. Went to bed last night and my heart went into skipped beat overdrive - it was just awful. Every other beat was followed by huge gaps, the beats were very strong.... I lay there for ages trying not to panic, but it really felt as though my heart was just faltering the whole time. Why on earth would it do that as soon as I had no monitor? I hadn't been worried about taking it back (was glad to be rid of all the wires, actually). During the week I had done everything I could to try to set them off - overate, had wine in the evenings, spicy food, nothing make it really bad. Last night returned to normal eating, no alcohol, and bang, there it was. Feel like I just can't win. :'(

Title: Re: They are back....so is the worry
Post by bseitz on Mar 22^nd, 2012, 2:48pm

Hi Rosekay...I had to reply to your post because I feel so much like you so often. I've had a ton of tests, seen multiple doctors and am going to an EP specialist on Tuesday because after not having any Palps for about a month or two they have started back the past few weeks and I had an extremely scary bout of them a week ago and my pulse was all over the place. Scared the crap out of me!!! Anyway, the doctors keep telling me its all anxiety, but I don't understand because I don't feel anxious until the Palps start. Hugs to you and hang in there :-)

Title: Re: They are back....so is the worry
Post by RLR on Mar 22^nd, 2012, 7:38pm

Okay, you're misinterpreting the circumstances Rosekay. You have to understand how much your brain has to do with influencing the palpitation events.

When patients wear holter monitors, it provides a sense of safety because they believe that it's going to determine the cause for the events that will hopefully lead to their successful treatment, or at the very least satisfy the patient that the holter has recorded the events. During this time period the patient is typically under a different state of mind than without the recorder, producing less incidence of palpitations in most instances.

When the monitor is no longer worn, apprehension slowly begins to return and the safety net of the holter no longer represents comfort, ultimately producing the same circumstances previous to wearing the holter and increasing the incidence of palpitation events.

I'm constrained to point out here that as physicians, we do not need to "catch" the events on the recorder to determine their nature. When we review an ECG, we are looking for the characteristic signs which produce arrhythmias which are of concern. In the absence of such signs, the patient's complaint of palpitation events can only represent those which are entirely benign in nature. It is only the patient who establishes the need for the events to be directly recorded in order to satisfy their unending worry that the events are both pathological and dangerous. Let me provide you with a common scenario from memory that typifies how patients are compelled to respond when discussing holter monitor results:

"There! Right There! Did you catch that one? I just had one. Is it showing up? Now what is it? Is that just the harmless kind? I've read that V-fib is dangerous and it has me concerned that the could be signs of V-fib. but you're saying mine are harmless, right? So they're definitely not V-fib, correct? What's weird is that I don't have near as many of these darn things when I wear the monitor as I do without it and it really frustrates me. You should see when they're really bad, like every 2 or 3 seconds or sometimes and it makes me light-headed like I'm going to faint. Is that normal? Can the dangerous kind do that as well? So then how do we know that the ones not being caught on the monitor are the same as the one it just recorded? I'm confused. Can you tell me for certain that these others are harmless too? I mean I know you've already said that, but you have no idea how much these darn things worry me. I just want to be sure. I can't even go do things that I used to always do because I'm so afraid that something is going to happen. I try and stay calm, but my thoughts just take off and I'm right back where I started. Is there anything we can do for it?"

So that's a brief example of the typical conversation from a patient wearing a holter. It's a struggle by the patient for reassurance which extends all the way to the events being potentially deadly. They just want the symptoms to go away and because the symptoms remain present, the patient once again becomes reinforced that something is wrong. Desperation can sometimes take shape because the patient can't seem to get relief from the unpredictable nature of the events and the sort of captivity it places upon them from being able to enjoy their life.

As long as you feel that these palpitations are dangerous or that they can somehow do harm, they will remain present. Only when you come to realize that firmly understanding the events to be entirely harmless with changes take place that cause the palpitations to diminish, sometimes entirely. There is no pill you can take to make them go away and regardless of how many times you have tests run, the results will always be negative because the relevant test equipment is designed to detect conditions which are harmful or that put the patient at risk.

You're going to be fine, but you have to begin looking to methods that will help restore your life once again and not persist in the belief that you are in danger or that more tests are simply needed to find the nature of the problem.

Best regards,

Rutheford Rane, MD (ret.)

Title: Re: They are back....so is the worry
Post by rosekay on Mar 23^rd, 2012, 1:10am

Bseitz - thank you for your reply. I wouldn't wish these things on anyone, but it is nice to know people understand. It just feels so horrible, doesn't it!? Onwards and upwards! Easy to say when it's not happening, I know. Hope you are feeling better, and RLR's reply helps you too
xx

Title: Re: They are back....so is the worry
Post by rosekay on Mar 23^rd, 2012, 1:15am

RLR - are you somehow reading my mind?! I can't believe how accurately you understand what goes through my - and lots of others' too I am sure - head. I am off to work soon but have printed off your reply and will really study it today. You are such a help, and I'm sorry to be such a nuisance. Best wishes and many thanks
rosekay

Title: Holter results
Post by rosekay on Jul 24^th, 2012, 8:28am

Hi RLR - you said I could post the Holter results when I had them, so here I am. Went to the cardio yesterday - unfortunately it wasn't the same man I saw last time, who really sounded like he cared and understood how the symptoms felt. This one was a lot younger and didn't really seem to be listening to what I said (my husband was with me and he thought the same, it wasn't just me!)

I had an echogram which showed my heart was functioning normally, which was reassuring. It was quite a long session so I did feel that they had a good look around in there! She did say that skipped beats were an electrical thing, which the echogram doesn't look at, but if there was an electrical fault, I assume my heart wouldn't be functioning normally.

The cardio said that the Holter showed normal heartbeat, even on the many occasions I had noted feeling skips and jumps. I asked about this, but he really didn't explain anything other than lots of people have skipped beats and some feel them more than others.
I mentioned that sometimes the irregularity was really bad and violent, actually feeling like my heart was jumping around in my chest. He asked when the last episode like that was - it was when I took the monitor back, 4 months ago. I told him that at the moment it wasn't too bad, it comes and goes in cycles - bad for a few weeks, then can be fine again for ages, no idea why or what triggers it. I said there was no pattern to it that I could see. Two minutes later he was asking how often it happens, which is almost impossible to answer!

In about a month I am having an event monitor for a month in the hope of catching a bad session, but he still expects it to be normal, he says.

He asked if I had any questions, but those I had already asked he didn't seem to answer. I know it will look like I'm never satisfied, and that I'm thinking "If only this or that had happened, or if only it had been the original cardio", but it was like he'd already written me off before I went in there. Since yesterday I have noticed more skips and flutters after it being pretty good for ages, so maybe the anxiety is building up again....

I know I'm not imagining the feelings in my chest, I can feel gaps in my pulse too - all of which I noted in the monitor - so how is that a "normal heartbeat"? I don't mean that I don't believe him, but am confused that things I feel as definitely abnormal and irregular and unpleasant are shown up as being 'normal' on the monitor - normal to me means the regular even beat, not this weird jumping about feeling!

I would really welcome your input and hope you are able to spare me a bit of time again :question

ps It's a couple of weeks since I posted, and although I've had little 'flips' they haven't bothered me really. Obviously I'd rather not have them, but at the moment it's ok!.. I really would like the violent episodes to be caught, just to let me know what it is really. I don't know how to trigger it though! I'm fed up with being worried, it's wasting my life and I've had enough of it.
Also - don't know if this relates to anything, but my thyroid count, which my doctor expected to be high, given the palpitations, has turned out to be borderline low and has to be kept an eye on. They said I would probably be on thyroxin before a year is out. Would low counts have an effect on palpitations?