Hi RLR, everyone,

I'm back with tales of woe!  Been doing well for over a year, exercising nearly every day, running 10ks 3 times a week and doing circuits.  No probs with ticker.  Hardly get any ectopics at all.  Resting heartrate 54.
Back in September I awoke in the middle of the night and noticed my heart was beating very fast.  I counted it and it was beating at about 150 - 160 bpm.  I became quite anxious after some time when it hadn't slowed down.  I worried about it for days after but it didn't happen again.  
I carried on running and doing all my other exercise.  Then it happened again one night and since then it has done it about 30 times, mainly in the middle of the night and sometimes first thing in the morning.  I've also had it happen while driving to work.  What happens is first I notice a weird sensation then my stomach feels all acidy and then I notice my heart get faster and faster.  It feels like it's never going to slow down.  
I know this appears to be a panic attack and I actually think that it probably is but I'm not sure whey I'm suddenly getting this happen to me.  So in October I couldn't exercise because of work commitments then my wife had to do jury service for a further two weeks and I had to sort out the children etc and again couldn't train. The following week I had to work nights and then I came down with a sickness bug, followed the next week with a cold and now I've got some sort of ear infection!  
So I have not been able to run or do any exercise properly for some time.  However the 3 or 4 times that I have afterwards my heartrate has remained very high in fact on one run my heartrate was 140 on finishing and dropped to 90 within a few minutes but after I had a shower it was back at 150 and stayed like this for nearly an hour!!  This has now given me anxiety about exercise as I don't want my heart to race post exercise!!!  
I'm also experiencing something totally crazy.  I was prescribed Locorten vioform ear drops for my ear infection and started taking them.  On day 2 I put 3 drop in my ear and almost immediately felt dripping at the back of my throat!  I know the ear and throat are connected but I didn't think the drops could go straight through like that!  
I was concerned because the drops have a warning that they cannot be ingested.  Soon afterwards my mouth started filling up with saliva and since then this has not stopped!  I've been to the doctors who say the eardrops are safe even if they go down your throat and my ear is now fine but they are completel baffled to why I should be producing so much saliva!!  So all in all I'm pretty fed up what with my mouth and my heart racing and not wanting to exercise anymore!  
I truly believe this is all anxiety and in my head but just wondered how best to break this loop and get back to my normal self.  
Hope you all are doing really well and hope you all have a superb Christmas.  Any thoughts RLR?
Best Wishes
Rich

Hi Richard,

With regard to the ear drops, it appears by your description that you may have a small perforation. Although you don't mention it, it is more likely that you are experiencing otitis media, or the middle ear, rather than otitis externa which is the outer ear canal. This is more particularly true if you if the ear infection was subsequent to an upper respiratory infection mentioned. The application of ear drops into the outer canal should not be able to surpass the tympanic membrane. These medications are often best delivered by repeatedly pressing the tragus, or the small skin flap that protrudes just anterior or in front of the ear canal, a process known as tragal pumping. If, however, you can taste the medication, then it is penetrating into the eustachian tube and into the nasopharnyx. Having said that, small perforations in the presence of infection are not altogether uncommon and most often self-resolve without further intervention.

The drops you mention contain a corticosteroid and an antibacterial component. The only concern in actually ingesting the drops is that the corticosteroid can sometimes induce adrenal suppression but in virtually all instances, this is observed in children only. I share your doctor's response that the drops in your case are entirely safe.

As for the saliva, I would ask whether you are experiencing any discomfort of your throat. If you are salivating to the extent that drooling is occurring, then I would suggest to you that it would warrant prompt attention by a look inside your throat to rule out the presence of a peri-tonsillar abscess. It's rather doubtful, but if drooling is present, then it would warrant attention.

Otherwise, if the salivation is merely more productive than you are accustomed to but not to the extent of drooling, then I would simply monitor it throughout the period of treatment for your ear infection and until the respiratory infection resolves to determine your post status with respect to over-salivation.

Concerning your elevated heart rate, there are a number of possible causes but I would wonder where you are presently with the upper respiratory infection or cold mentioned. If not resolved, then it can indeed play a role in the manifestation of sinus tachycardia.

It does not necessarily suggest that you are experiencing panic threshold events, since the realm of symptoms associated with such events is quite characteristic among most persons who suffer them and you make no mention of other symptoms to support it. The fact that the tachycardia is extending for periods up to an hour would typify the need to have the episodes evaluated on ECG. I do not believe they are life-threatning, nor do they suggest any type of arrhythmia is present which would warrant intervention. It simply suggests that they've occurred at a frequency rate which would require direct assessment before I would be able to comment further.

You'll be fine. I would seek to obtain an ECG if the events can be captured in your physician's office or a holter to discern their character when they arise.

Please keep me posted and let me know the results of any visits if you care to comment and I'll provide response.

Best regards and Good Health