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question for rlr (Read 11241 times)
lee
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question for rlr
Jan 16th, 2012, 9:09pm
 
Just a history. I'm 40 and in good shape with no health problems and no family history of heart disease. I just had a physical and blood tests and everything was fine. I have had bad palps the last few years. I have had an ekg, echo, stress test, holter monitor and cardiac cath. I have also seen a cardicac rhythm specialist. All tests came back negative and they told me my heart was ok. I have a few questions.

-You say vagus nerve palps originate from outside the heart like a twitching of the eye. I am curious if the palp we feel is the hearts reaction to the vagus nerve? Is what we feel actually our heart doing the flip flop? Does that make sense?

-My cardiologist told me to get my thyroid checked and was I guess telling me my thyroid might be causing palps. My tsh level was 6.21 and I guess that is considered high. Could this be a cause? My regular doctor suggested medicine but I don't want that. Could this be why I feel crappy?

-Ligtheaded/Uneasy/Dizzy/Foggy/Just feeling off. This is the worst feeling ever. I admit i have health anxiety and always feel something bad is happening. Is something wrong with my heart and trying to tell me something or are these symptoms caused by anxiety? Its so hard for me to believe this horrible feeling can be the result of anxiety.

-We talk about how when we go to the doctor the palps are never visible. If I truly had a dangerous arythmia or problem with my heart would all the tests Ive had without a doubt pick this up or do we have to see these palps on the tests? Am I in the clear with all the tests I've had?

- I still feel that there is truly something wrong with my heart. I get dizzy and lightheaded all the time which I fear is my heart telling me something. When I play hockey my heart lurches and bounces all over the place, ba bump ba bump stop and pause then hard beat after and this repeats itself. How can this be normal? I feel crappy after the game but maybe its from the incredible fear I go through. I cannot rid myself of these fears and it is ruining my life. Do I need to go back to the cardiologist and have more tests? If I had a dangerous arythmia wouldn't the tests reveal this? I don't want to spend more money but I want to know I am ok. Please help me RLR> These palps are terrible.
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RLR
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Re: question for rlr
Reply #1 - Jan 17th, 2012, 6:27pm
 
Indeed, the sensations you experience as palpitations are merely the heart muscle responding to wayward nerve impulses arising from the vagus nerve. The "flip flop" sensation is due to the fact that the heart is in motion and depending upon precisely when these irregular nerve impulses arrive, the characteristics of the subsequent sensation can vary.

Thyroid irregularities can indeed produce palpitations, tachycardia and bradycardia among other characterizations. While your TSH is elevated, it's important to look at the entire thyroid profile such as T3 andT4 values in order to establish more precisely what may be taking place. In general, however, medication is rarely considered advisable subsequent to a single thyroid panel test. If subsequent test 6 weeks or so later reveals similar values, then other tests and/or treatment options are normally discussed. This latency in treatment is because a number of factors can produce irregularities in the thyroid values which are transient in nature. Treatment should only commence if the high values are observed on secondary evaluation a few weeks or so apart from the original test.

Indeed, thyroid dysfunction can cause all of the symptoms you describe but I am constrained to point out that all of these symptoms are just as easily produced by significant stress and anxiety. Indeed, anxiety of a certain type can produce physiological disturbances which patients misconstrue as symptoms of disease.

As I have mentioned many times on the forum, true disease cannot suddenly hide from detection or its symptoms suddenly abate in the presence of medical evaluation. Such an observation is of high clinical significance that the underlying cause is functional, rather than organic, in nature.

The tests you've undergone would reveal any sort of underlying problem related to your heart. You feel certain that something is wrong because of your perceptions about what the palpitation events actually constitute in your own mind. When tests such as those rendered prove negative, then any persistence in contrary beliefs must unavoidably be held to great scrutiny regarding their origin in fact or fiction. You are basing your fears upon what you suspect or fear, not what the tests actually state as medical fact. Such tests are extremely definitive and accurate. They are not an approximation or derived by hit-or-miss technology. When you find yourself making a contrast between these sort of tests and your own subjective concerns and demonstrating preference for your own rationale, it very strongly indicates the need for self-examination and drawing questions of whether the means by which you stand so firm in your beliefs are rational, logical and scientifically sound. It is the persistent fixation to one's beliefs about fearful prospects which reveals the true nature of the circumstances.

You are not concerned whether you are right or not, only that you maintain vigilance to factors which you believe are placing your life at some measure of risk, which in all reality is not anywhere near the truth at all and extremely inaccurate. These palpitations produced by the vagus nerve have no more capacity to harm or stop your heart than plucking an eyebrow will result in a stroke. You do not understand their actual nature and therefore, they constitute a risk of unknown magnitude. In other words, if you don't know how they function, then they are just as capable in your mind as being deadly as they are harmless. You do realize, however, that such plausibility is not reality-based, but derived through subjective fear.

The very existence of this forum should cause you to pause from your headlong pursuit in the belief that you are in danger. You're not and that's not going to change simply because you believe it is somehow possible. You are suffering these manifestations because you believe your life is in peril from their presence and the brain responds in a very particular and unrelenting manner to any feedback that survival is at risk. This happens where the risk is real or merely perceived and as long as you persist in your beliefs, then the brain will continue to compel you to seek safety and identify the threat in order to either challenge and overcome it, or escape from it. That's how humans are genetically programmed to react to matters that challenge survival.

You're going to be just fine and you are in no danger whatsoever, regardless of how hard you try to prove otherwise.

Best regards,

Rutheford Rane, MD (ret.)
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Best Regards and Good Health
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lee
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Re: question for rlr
Reply #2 - Jan 18th, 2012, 11:32am
 
Rlr- I want to ask you one more thing. When I'm playing hockey the palpitations I have  feels like my heart stops for a second and then kicks in real hard again. Its like ba bump ba bump ba bump stop(pause) then starts again. I understand a vagus nerve palp as an extra flicker that you feel that doesn't hower interrupt the heart beat. Like a normal heart rate with a little static charge thrown in but the heart remains at a normal beat. What scares me is that my heart feels like it is struggling and it stops for a second and struggles to stay on a normal heartbeat. Does that make sense? I feel like mine is far worse than just a minor hiccup. Mine feels like a major interruption of the heartbeat versus what I feel as a vagus nerve palp where the heart beats normal with an extra charge but the heart stays on a normal rhythm. Can you help me here? It just feels so horrible and not normal. I don't want to die on the hockey rink and I hope its not something serious that has been missed.
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lee
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Re: question for rlr
Reply #3 - Jan 18th, 2012, 11:46am
 
What I mean RLR is that you describe the heart beating like a pendlum on a clock and the vagus nerve sends a palpitation but the pendlum is not interrupted. What confuses me is that when I'm playing hockey and my heart literally feels like it stops for a second how in the world is that not interfering with the pendlum on the clock? My heart is stopping (pausing for a second) and to me that halts or stops(interrupts) the pendlum. This happens over and over again while I'm playing.  This seems so much more serious to me than a twitch or extra fire of the vagus nerve. The heart is pausing therefore stopping the pendlum. How can the pendlum be uninterrupted when I feel my heart is completely out of whack and not beating right? Please help me make sense of this?
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Re: question for rlr
Reply #4 - Jan 18th, 2012, 11:48am
 
I also feel like the dizziness/lightheadedness/fogginess I have is the result of my heart not working properly and when it beats irregularly this is my bodys way of telling me somethings not right and thats why I feel dizzy. I wish I could say it was due to anxiety and I would feel so much better..
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Re: question for rlr
Reply #5 - Jan 19th, 2012, 7:17pm
 
Rlr- I was hoping you could answer my questions above
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Re: question for rlr
Reply #6 - Jan 19th, 2012, 8:09pm
 
lee wrote on Jan 19th, 2012, 7:17pm:
Rlr- I was hoping you could answer my questions above


Relax I'm sure he'll get around to it, he tends to visit the forum and answer questions every few days or so.
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lee
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Re: question for rlr
Reply #7 - Jan 25th, 2012, 2:23pm
 
Hi rlr- I hope you get around to answering some of my questions above. I'm having a bad day with alot of hard palps and not feeling well with alot of anxiety.. I so feel like something is wrong with my heart. It lurches and drops and feels like it's struggling. I quit playing hockey now because it stops and skips and jumps all over when I play.. I've had all the tests that turn out ok but I'm so depressed. I hope it's just anxiety but can't come to terms with why my heart behaves like this? I feel like other people's palls are just a minor skip or hiccup but mine are so strong and forceful on my heart. How can a perfectly healthy 40 yr old with no family history of heart disease and stays in great shape by exercising have these terrible heart erratic forceful beats?
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Re: question for rlr
Reply #8 - Jan 25th, 2012, 3:00pm
 
Hi Lee,

I can tell you are struggling with your fears about your heart and trust me I understand.  I have been through a lot with my health and my current symptoms have me baffled as well as my Dr's.

But regarding your heart.  Sounds like you have had all the necessary testing and all looks good.  I get skipped beats, hard thuds (and currently the tachycardia and am wearing a holter monitor as we speak)..  

I use to get the hard thuds that would skip as well and then I would get a dizzy feeling with it. So I do understant your worry.  I know right now I am worried about all I am going through, but I know RLR knows his stuff (even though I keep asking the same questions over and over) and he would not tell you that you are in no danger if he didn't mean it.  I know he can't evaluate you in person, but by your descriptions and medical testing he can rule out in his mind what is NOT happening.  I am sure you will be fine...  Hang in there as frusrating as it is.

Do you drink a lot of carbonated drinks?  I know in the past when I drank soda (quit drinking it and caffeine altogeher since all my health stuff happened as of recent) and when I had the skipped beats and thuds, it went away gradually the more I eliminated certain thngs like carbonated drinks.  Try not to focus on it too..  I am not one to talk trust me, I am sooooooo focused on what I am going through, but seriously, just distract yourself and when your heart does that remind yourself that you had the appropriate testing done and your heart is healthy...   My best to you..
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lee
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Re: question for rlr
Reply #9 - Jan 25th, 2012, 4:02pm
 
Thanks Stef for the kind words. I drink alot of Starbucks coffee but not much pop.. I have a large Starbucks every day and it's strong. I don't get dizzy right after a palp, I'm just kind of dizzy/lightheaded all day long.
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