ttt

Palpitations are my latest obsession and have been for the last 3 or 4 weeks. I am at my doctors every other day because of them. I ended up in the ER a few weeks ago with an elevated heart rate and sky high blood pressure. The ER doctor insisted I take two Valium which I refused. Then he said "if you want the blood pressure to go down take the Valium" so I did and my heart rate and blood pressure returned to normal within an hour. An ECG showed normal sinus rhythm and blood tests were all normal. Anxiety was the diagnosis. Of course it didn't end there, hence the now regular visits to my doctor. Or should I say the now regular visits for palpitations because before that I was a regular visitor for a never ending list of ailments. Last week my doctor told me to find the pulse in my neck and put my finger on it for 2 minutes and the palpitations would stop. I tried it and sometimes it works. I suspect that he suggested it because he figured it would distract me from the palpitations long enough for them to stop. I should probably also mention that it was on that day that he wrote the referral to the psychiatrist. My first appointment is in March. I guess that I have at least stopped focusing on every other area of my body. That is if you discount Friday. On Thursday night I developed an ulcer on my tongue and turned up at the doctors on Friday worried that I had tongue cancer. The mind is a powerful thing and mine has got the better of me. Can I just say that I am a school teacher but I also have a degree in Psychology. It has not helped me one little bit. If self-analysis is possible then I don't have the knack for it. Until the ER incident I would have said "don't take the sedatives" but I have been taking them for the last 3 weeks. Only if I am feeling particularly anxious. So sometimes only 1 each day. I want to take none at all and I want to stop having to take blood pressure medication. So I know I need to get on top of the anxiety. I don't know how RLR feels about sedatives but I would be interested to read what he has to say. Good luck, I hope you feel better soon.

Okay, I've read your posting and concerns. There are several points to be discussed here. Firstly, we need to draw attention to the underlying concern which is fueling your apprehension in contrast to the actual circumstances. Virtually all persons who experience palpitations of this type become overwhelmingly concerned that the events hold the capacity to induce a cardiac event or transform into some type of dangerous arrhythmia that is very unpredictably placing their very life in danger.

Frustration is quite common and is largely manifested by repeated failure of the medical community to singularly define and resolve the symptoms, the nature of which impose the aforementioned risk to such a proximal extent. In other words, patients feel helpless in the presence of imminent risk while the medical community seems unconcerned and ambiguous regarding the need to resolve the symptoms and restore a sense of safety to the mind of the patient.

The use of beta-blockers in the context of arresting palpitation events is considered off-label. Although beta-blocker therapy can reduce cardiac force and augment regulation of heart rhythm, the drug demonstrates no efficacy, or effect, upon factors which cause vagus nerve-induced palpitation events to occur. Any brief respite experienced in such cases is universally due to common placebo effects. It is of importance, however, that the same force which produces placebo effect is also capable of actually reducing the incidence of the palpitation events within the same time-frame. The inability of the drug to impart positive influence is due to the mere fact that the palpitations in such instances are extra-cardiac in nature, meaning that they arise from outside the heart.

It's also important to note here that the premise of frustration toward your condition and the medical community is to a large extent manifested due to your rather firm perceptions that the underlying cause is due to an underlying organic, or physical, problem. It is natural to presume that physical symptoms constitute a direct relationship to underlying physical cause, but in fact this is actually not the case at all. Additionally, the perception that physiological sensations constitute physical symptoms is actually in question as well.

The discussion of these points is not to suggest that "it's all in your head" by any means, but rather to point out that perception of what is causing your physical symptoms versus the actual cause is partly to blame for your frustration. Since your heart is the source of the symptom, then it only seems logical to pursue evaluation and consult by a cardiologist or similar specialist. Despite the fact that most all tests by patients using this approach result in negative evidence for underlying physical disease or causal factors, patients are nevertheless compelled to stay the course because their symptoms will not abate.

So we have several elements here to entertain when attempting to draw reference to underlying cause for your symptoms. It's important to focus upon facts within your posting which can offer direction. You've been to three cardiologists and many regular MDs and yet nothing was ever found. If we examine this premise, logic forces recognition of the fact that regardless of how many physicians and specialists evaluate the symptoms, no underlying organic cause can be found. Again, this is not to say that the symptoms are not physical or real, but merely that the underlying cause is not based in organic pathology. All diagnostic test equipment is patterned by algorithms based upon real disease and if test patterns from the patient do not match the algorithms, then no disease is present. This is a medical fact rather than presumption.

The core of the problem here is that you believe yourself to be at imminent risk at some point due to the presence of the palpitations and feel compelled to continue searching for the cause to obtain both resolution and a return to a life where you feel safe once again. It is at this juncture you must bring to question whether you are actually at any risk at all and whether your concept of what the palpitation events represent is accurate to any degree. Until you successfully resolve this contradiction, the patterns being demonstrated will continue. You are frustrated by all the diagnoses because you are seeking the answer based upon your own interpretation of the underlying cause.

In answer to your question, there is no magic pill which will abate or diminish palpitation events of this type directly. They are a manifestation of an internal climate of stress and anxiety. Also understand that the anxiety or stress itself does not produce the events, but rather that the events are produced secondary to changes in the central nervous system which are caused by the stress and anxiety. Your concerns are growing because you feel that at your age, the risk of harm is now more imminent. Again, you must come to question whether your interpretation of the problem and the consequences is accurate. Careful reflection of all that has transpired can provide a great deal of insight and subsequent reduction in symptoms. Here are some facts that will help point you in the right direction.

Age has absolutely nothing to do with whether palpitations of the type you are experiencing pose greater risk. I'll share with you here that throughout medical history, there has never been a single recorded case of a patient suffering any harm whatsoever from the type of palpitation events you are experiencing. Not a single case. I'm now 93 years of age and most of my patients grew old with me and under my care, many of which experienced the very same palpitation events you experience. Not a single one of those patients ever came to harm or expired prematurely as a result of the palpitations. The events cannot wear out your heart, causes any type of cardiac event to ensue or even produce some type of dangerous arrhythmia. Such a premise is rooted in your interpretation of their potential, not the actual facts.

"I've been to so many doctors. They all say that nothing is wrong. I'm FED UP."

I highlighted this comment merely to offer insight regarding the premise under discussion and a source of the persistent conflict. Your statement reveals that you are frustrated because your doctors are unable to find the cause that you believe to be present. Consequently, the perception is that your physicians demonstrate contradiction and incompetency. In other words, you have adopted a sense of increasing risk associated with the palpitations with respect to advancing age and despite the passage of time and increasing risk, your doctors are unable to find the underlying cause.

"That way my mind can relax. My mind will not relax, until the palpitations stop. I don't know why, but that's just the way I am."

I also wanted to highlight this comment because it is extremely common among persons experiencing symptoms similar to your own and actually constitutes an ultimatum. In other words, you refuse to relax and accept the facts until your symptoms abate. This is a very important because you need to realize that your state of mind with respect to the apprehension being generated is driving the forces which produce the symptoms. Your mind won't relax because you are rigidly adhered to your perceptions rather than the facts.

You are in no danger, regardless of how old you become, as a consequence of the presence of the palpitation events. The key to change is exchanging irrational fears for logic and medical facts. It's important to realize that the "way you are" has a lot to do with the presence and persistence of your symptoms. There is nothing medically wrong with you.

Best regards,

Rutheford Rane, MD (ret.)

nice one bayroot.

offcourse Skipabout is anxious about his sensations.
And because he is anxious, and he has skipped beats its anxiety.
But somewhere down the line it started somewhere. And he described he wasnt anxious back then.
So everybody understands if you are anxious of symptoms you have anxiety and that maybe due to changes in nervous system due to the anxiety arousal you maybe get (more) sensations.

But where did it start?
why?
As for all I know I never was anxious BEFORE my sensations started.
So where did it begin?

I quess thats whats puzzling people.
Also the different diagnosis you get. Although no one find anything SERIOUS. which doesnt mean there isnt something wrong and causing this. the explanation you get is mostly different. and they are all well educated medical professionals.

Like I always say.. some think I do have a neurological issue, some dont. They all are experts.
And offcourse people do make mistakes. doctors too.
So that issue is always there if you have a tendency to be occupied with your heatlh or symptoms.

I still believe that explanation is the key !!
Not the explanation. Everything is ok , I cant find a problem, maybe anxiety. No whats causing this, and why isnt it..this or that disease. what can you do about your symptoms? explain !

Why does one man get a heart attack although everything seemd fine a year ago. and is everything ok in me?
Why is tingling and numbness a neurological symptom in many feared neurological problems.. but why when I or someone else has it it is without even an MRI or anything, it's not a problem?

Asking for  answers is considered hypochondric i quess. If person A says.. its ok.. than you have to accept that. But in these times with internet and all diseases flying around you , and you hear of everything in a sec, we need another approach. Tims are changing. People know and question more due that everything is available to us . In my book its a fair question which can help you to get you on your way to a better understanding and dealing with your problems.

And please dont take this the wrong way. When I am 93 I will look back to things with probably more calm , but I very well would like to get to my 90;s too. and fact too. not many people get there.
But I do miss the simple fact that sometimes things are wrong even though people thought it was not. people do get sick. and develop many illnesses. So better safe than sorry.

offcourse living in fear is no option. But its not strange that people reflect to a period they didnt had these symptoms and think , what the hack went wrong? I didnt used to have this, so what changed?

I accept anxiety as a problem. and a not helping one. but its not always the cause but just as mucht times  the effect . the effect itself is not helping the cause.