![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
Entry tags:
I was going to write a post about books...
Monday night, after posting on Goodreads, but just as I was about to close Goodreads and come here, I had another v-tach episode. This time, the new programming on the device kicked in so I got "paced" out of the event rather than shocked out of it, which is less violent and less painful, but it's still no less alarming and disconcerting, and it's very, very alarming to have another episode only a few weeks after the previous one. More about how I am coping with this soon.
no subject
http://en.wikipedia.org/wiki/Valsalva_maneuver
no subject
How are you doing? Is your pacer also an ICD? Am I recalling correctly that you didn't use to have tach episodes this frequently, either? I wonder if the extremes of hot weather we've been having could be what's making us do worse - if so, then there's probably thousands of others out there also suddenly doing a lot worse than they were a couple years ago.
no subject
I have a crt-d with the three leads. When it tries to pace me out of v-tach it's not all that perceptible over the other erratic flipflops my ticker has.
I had a svt attack a few days before that caught me totally off guard and at a bad time, no one home to take me to the ER. I waited and watched as the rate went from 130 to 155 over a 15 minute period and the BP was climbing with it, 150/110, and increasingly bad angina when I decided to call 911.
At the ER, the rate had dropped back to near normal, but went back up again several times before the pacemaker tech got there. He downloaded about 100 pages of data from it and pointed out where he thought I'd had the first svt episode and also showing where the pacemaker was working to pace me back out of it. ( I had no idea they could do that!) He mentioned something about improved algorithms. They sent me home a few hours later, loaded with IV beta blocker and a prescription for more metoprolol. Ugh.
I tried to keep on the stuff, but my BP was so low my home monitor couldn't take readings. And I was nearly fainting when I stood up. so I stopped the pills and felt better right away. I was having trouble sleeping too. Tach hitting me when I dropped off to sleep, waking me up in a panic trying to catch my breath.
I had a regular internists checkup scheduled later that week and when I mentioned what was happening he immediately zeroed in on obstructive sleep apnea, but I assured him that wasn't the case, I don't snore, the wife never heard me stop breathing and I never sleep on my back, just my sides. Then he pointed out it could be 'central sleep apnea' and I blinked, never heard of that before. Anyway the checkup was ok.
I went home to look this thing up on wikipedia and sure enough, that sounded about right. The internist had mentioned doing a sleep study but I wasn't too keen on that. So I looked into what treatments there are and, sheesh, they started out talking about $6000 breathing aids. But further sleuthing found a lot more options. The first and cheapest is to just pile the pillows high and sleep propped partially upright. That worked and I slept pretty good with no more apnea and tach events... for a few weeks.
But things changed again. Had some tach events while reading on the laptop, hit a very stable 137 bpm and no change for over an hour. The BP didn't go too high so I just waited it out. Tried the valsalva maneuver a few times, no luck. Got me wondering what else was going wrong.
Did more looking up things on wikipedia, hoping to see what else could make me do this stuff. One thing I did find was something called Roemheld syndrome. It's a complex interaction of the vagus nerve, the digestive tract and the heart that can result in pretty much the same problems I was seeing. Many of the contributing factors are ones I have a family history of. Now I'm thinking if it's worth the extra tests and such to prove it. The treatments seem the same as normal chf so like I was told a long time ago - 'before doing a test, look at what you'll do if the test passes and what you'll do if it fails. If it's the same thing, don't do the test.'
Now as to what might be happening, well, I'm pretty sure heart failure isn't a stable situation. In my case, because I had the three lead CRT-D pacemaker, my ef went from less than 15% to more than 40%. Sadly the ef has been dropping over the years and last fall it was 22%. Obviously other things are changing in the chest as the heart size remodeling reverses then remodels again, like the relative positions of the lead electrodes proximity to the phrenic and vagus nerves. At first I had a lot of trouble with pulsing the phrenic nerve causing diaphragm spasms, but those slowly disappeared. Now I think the vagus nerve is getting pulsed when I exhale and I've had a meal and I'm tired, setting up this Roemheld syndrome. Something I'll talk to the cardiologist about at the next appointment.
Whatever it is, it's not lethal, just darned uncomfortable.
no subject
(In tangentially related news, I think I found you on Goodreads, which for some reason I hadn't known you were on.)
no subject