Had a scare today.

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randian

Had a scare today.

Post Number:#1  Post by randian » Fri Aug 02, 2013 2:42 pm

Went to the ER with mild chest pain and chest tightness. Tests suggested possibility of clots and a calcium score of 30. Lung CT showed no clots (yay!). Not sure what the chest X-Ray showed, I never saw it. They tried for 5 hours to get my heart rate down far enough to get a heart CT with contrast done. It never worked. 3 pills of Metoprolol, 2 IV push of Metoprolol, and 1 IV push of Atavan later and they still couldn't get my heart rate below 90 (about 99 when admitted). Plus plenty of now-useless nitroglycerin. So no heart CT got done and no direct evidence of blockages or plaque buildup. But the two heart enzymes a few hours apart looked good, as did the EKG, so no heart attack. No additional pain from light exertion, and the tightness is positional dependent (worse lying down, almost invisible sitting or standing up).

So in the end I have an appointment with a cardiologist for a stress test since there were no specific heart issues showing up. Oh yeah, the blood tests they did for cardiac enzymes revealed my glucose was 260. Not a real glucose loading test, but still! I don't know if those tests are screwed up by high vitamin C like handheld meters are. I suppose not, so another appointment with a PCP. I'm getting that glucose level even thought I'm not eating soft drinks or sugary snacks. Lame. Probable insulin resistance.

The doc said the calcium was "pinpoints" so apparently I'm in the beginning stages of calcification of my blood vessels and probably other tissues. I don't anticipate large blockages given that description, but what do I know? I've been taking the LEF Super-K for more than a month now along with 10000+mg C, 50,000 IU A, 10,000IU D, and 2,000 IU E daily. I've also been taking ~4800mg of lysine and 1600mg of proline daily, for about the same amount of time. Plus Bs, ALA, 50mg zinc (as zinc gluconate) and 400mg magnesium (as magnesium glycinate). I hope the score is better than it was when I started. How long does this sort of thing take to reverse? I'm definitely going to push back on statins if the doc recommends them. I don't know why they would, since I have no clotting issues.
Last edited by randian on Sat Aug 03, 2013 11:18 am, edited 3 times in total.

Johnwen
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Re: Had a scare today.

Post Number:#2  Post by Johnwen » Fri Aug 02, 2013 9:10 pm

Just from what I'm reading here it could be a vagus nerve problem?
After you went home did your pulse drop?

Here's a study on vagus nerve from the year 1911 and it hasn't been disproved yet 102years!!!
So it stays in the system!
The reason I like this study is they used human subjects back then.
Even though none were harmed in the project.
Anything you read after this is on dogs, cats, rats and monkeys.

http://www.ncbi.nlm.nih.gov/pmc/article ... df/217.pdf
To steal ideas from one person is plagiarism. To steal from many is
research!

randian

Re: Had a scare today.

Post Number:#3  Post by randian » Sat Aug 03, 2013 12:10 am

Johnwen wrote:Just from what I'm reading here it could be a vagus nerve problem?

I don't understand. That paper says that stimulating the vagus nerve slows down the heart. How is that related to the drugs' inability to slow down my heart? Are you saying the vagus nerve is sending bad signals to my heart? Is that even a correctable problem, if it is a problem?
Johnwen wrote:After you went home did your pulse drop?

I didn't measure it at the time. A quick check right now estimates my resting heart rate is ~100, just like the heart monitors at the hospital were showing. It did get as high as 108 in the ER. Situationally-induced stress? I guess my heart just likes to run fast. I thought it somewhat disturbing, but neither the nurses nor the ER doc saw fit to mention it as an item of concern. They were frustrated the meds didn't work, but chalked it up to "just doesn't work on some people".

My BP was good, 122/75 on admittance, and as low as 110/65, probably a side effect of the nitroglycerin patch (which I was told dilates blood vessels) they gave me. I can't be certain (lacking a control) but I hope the good BP is due in part to my supplement regimen.

The nurses were nonchalantly talking about putting a stent in if any (they didn't qualify that by percentage) blockage was found. Given what I've learned about stents from this forum, I found that quite distressing.

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Re: Had a scare today.

Post Number:#4  Post by Johnwen » Sat Aug 03, 2013 10:02 am

This might sound off base at first but you’ll see what happens.
During heart transplants the nerves of the new and old heart are severed so there is no nerve control to the new heart implanted and the heart runs on it’s own. It runs in the range of 100bpm. Vagil regeneration does occur and is evidenced by a drop in heart rate usually 70-80bpm. So as you can see the without the vagus nerved attached the heart rate will increase.
Things that can cause the vagus nerve to not function in regards to the heart are any type of irritation to the digestive system. Which if you think about it makes sense because if your GI system is fighting a bug or whatever you would want an increase in blood flow to this system to bring the necessary counter measures to correct it. Since the GI distress is flooding the vagus nerve with signals this overload would take away from the signals to the heart which in turn would be a blocking the nerve impulses to the heart which would cause an increase in heart rate.
As you noted in the laying position your pain increased in your chest area and decreased in the upright position. This is a pretty good indicator of GERD or just an agitated stomach adding an increase in stomach acid to over power an irritant which is backing up into the esophagus.
Since they ruled out any immediate cardiac problems and beta blockers didn’t show any response it pretty much points the finger at the tummy area. I would try something like tums or baking soda in small dose on a empty stomach and see if it reacts with a large BURP! If it does it’s a pretty good indicator your stomach is responding to some kind of irritant and might be worth going through your consumables to see what may be causing the irritation. You might not notice any discomfort’s because the stomach is well capable of handling any increase in acid. The esophagus isn’t and is usually the first to show sign’s.
One last note! You did the right thing by getting this checked out even though it made you more aware of what’s going inside but it showed you weren’t in any immediate danger. I’ve seen too many young people not make it because they thought it was just a stomach problem or they were laid off and didn’t have insurance and thought is would pass. It didn’t and they did!
So now you can relax and take some time to set out a plan of action to get things right!
To steal ideas from one person is plagiarism. To steal from many is
research!

randian

Re: Had a scare today.

Post Number:#5  Post by randian » Sat Aug 03, 2013 11:16 am

Johnwen wrote:As you noted in the laying position your pain increased in your chest area and decreased in the upright position. This is a pretty good indicator of GERD or just an agitated stomach adding an increase in stomach acid to over power an irritant which is backing up into the esophagus. Since they ruled out any immediate cardiac problems and beta blockers didn’t show any response it pretty much points the finger at the tummy area.

The doc did note the unusual presentation (right side pain). Is it normal for GERD not to be felt in the abdomen? I do not have heartburn or acid reflux. I don't feel any esophageal or GI distress, it's all in the chest not the belly. Maybe a little queasiness, but I assumed that's just the stress of contemplating heart failure (and I had hardly eaten anything since the day before because of a tooth extraction).

Could antibiotics be an irritant? I'm taking 500mg cephalexin 4x/day for a tooth extraction. I'm adding a live culture probiotic a couple of hours after each dose of cephalexin to try to keep the intestinal flora going.

Just how worrisome is that calcium score (I'm told the number can run in the hundreds) and is it likely to be reversible with vitamin K supplementation?

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Re: Had a scare today.

Post Number:#6  Post by Johnwen » Sat Aug 03, 2013 12:25 pm

Is it normal for GERD not to be felt in the abdomen?


Johnwen wrote:You might not notice any discomfort’s because the stomach is well capable of handling any increase in acid. The esophagus isn’t and is usually the first to show sign’s.


The esophagus and the heart are very close to each other. That's why they call it heart burn!

Drop down on the LC probiotics to Once a day away from the antibiotics!!!! Geeez talk about starting a war!!!

Did they give you a shot for the pull or did they use sedation? :?:

Calcium testing shows plaque that has stabilized and got coated over with calcium. Their the done deals and pose no risk however a person with a lot of long/large ones could mean active athroma a lot of little bright ones show's a period where the patient had problems with the endothiel cells and was problematic at some point these are old ones. Dull or dark means fresh and could mean they are active now! A few here and there is no big deal if all else checks OK! Calcium scores is not a real good indicator but it is pretty good to decide if further testing needs to be done. Their accuracy is in the eyes of the reader of the test some know how to read them other's well not so much!!
To steal ideas from one person is plagiarism. To steal from many is
research!

randian

Re: Had a scare today.

Post Number:#7  Post by randian » Sat Aug 03, 2013 1:57 pm

Johnwen wrote:Drop down on the LC probiotics to Once a day away from the antibiotics!!!! Geeez talk about starting a war!!!

Ok.
Johnwen wrote:Did they give you a shot for the pull or did they use sedation? :?:

Shots. Four to the gums and one very painful one to the palate. I'm glad the brain is very efficient at forgetting pain. I also had a full cleaning on that side of the mouth prior to the extraction. Next week they're cleaning the other side and extracting one tooth on that side.
Johnwen wrote:Calcium testing shows plaque that has stabilized and got coated over with calcium.

Is Pauling therapy effective at eliminating or reducing these plaques, or are these a different kind than those that form the blockages that some here say they have successfully reduced or eliminated with Pauling therapy?

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Re: Had a scare today.

Post Number:#8  Post by eDOC » Sat Aug 03, 2013 7:13 pm

Anxiety > Excessive cholinergic discharge > palpitations, should have given you an antichoinergic drug.

GERD & Angina have similar & at times atypical symptoms.

GERD increases the risk of angina & coronary vessel vasospasm.
Rookie, rusty, sub average doc but one that gives results!

randian

Re: Had a scare today.

Post Number:#9  Post by randian » Sat Aug 03, 2013 10:35 pm

eDOC wrote:Anxiety > Excessive cholinergic discharge > palpitations, should have given you an antichoinergic drug.

If I was suffering palpitations the docs didn't mention it.

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Re: Had a scare today.

Post Number:#10  Post by ofonorow » Sun Aug 04, 2013 10:33 am

Randian, sorry to hear about your difficulty, and I defer to the very experienced johnwen, who seems quite sure based on the information that you provided that this isn't a heart issue per se.

It is fascinating about the vagus nerve and the old finding that without it's influence - that the heart beats at approximately the rate yours is.

As far as GERD, in my experience, it occurs approximately 6 hours after a meal if one is lying down. (As if when the contents of the stomach empty into the lower intestine, the sphincter between the stomach and esophagus relaxes, releasing some stomach acid into the esaphagus.) I have tried the tablespoon of vinegar - which does work, probably by shocking the sphincter closed. However, a very recent solution that is much more pleasant - I take a glass of whole milk just before bed. For what ever reason, this works.

And this may or may not be related to the vagus nerve, but when I was in the hospital for what turned out to be the finding of a "lesion" on my pancreas, I had chest pains. So I reported them, went through a thallium stress test, and passed with flying colors. During the operation on the pancreas, they removed a very "distressed" gallbladder. I have a feeling some of the "heart pains" I felt had to do with gallstones.

Anyway, johnwen, is there a connection between gallbladder/stones and the vagus nerve?
Owen R. Fonorow
HeartCURE.Info
American Scientist's Invention Could Prevent 350,000 Heart Bypass Operations a year

randian

Re: Had a scare today.

Post Number:#11  Post by randian » Mon Aug 05, 2013 6:34 pm

Went into the ER again for significantly more right-side chest pain. Same diagnostic non-result. The attending ER doc ordered me 25mg metoprolol, 500mg metformin 2x/day, and low-dose (81mg) enteric-coated aspirin. I have an appointment with the cardiologist later this week.

The metoprolol is a beta blocker. I read here that they stop the body's production of CoQ10. I've been taking 200mg/day of ubiquinol, supposedly the equivalent of 400mg ubiquinone. In any case, should I up my intake of CoQ10 to compensate?

It's not clear to me what the doc is trying to accomplish with the metoprolol. I was showing no arrythmias on the EKG, just a too-fast regular sinus rhythm. I took one dose so far today and my heart rate is still about 100. If GI distress wigs out the vagus nerve to let the heart run unregulated, and I am suffering constant GI distress right now (not to mention constant right-side chest pain), now doubt worsened by the metformin, that's exactly what I expected to happen.

Of course, with my GI distress who knows what nutrients I'm actually absorbing. I'm keeping up with my nutritional supplements, but my appetite is shot to hell and it's a major effort to eat the equivalent of a 6 piece chicken mcnuggets (i.e. not much food). I certainly don't feel good doing it. I must be running well under 1000 calories a day right now. My energy levels are shot to hell too.

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Re: Had a scare today.

Post Number:#12  Post by bbtri » Mon Aug 05, 2013 10:27 pm

This anecdote may or may not be relevant to your situation. I was having back and chest pains on the right side at night. My heart was fine and blood pressure optimal. I had a lipoma on my back that I thought could be pressing on a nerve and causing the pain. GP and surgeon thought it unlikely but possible. Regardless they thought surgery was a great idea. Since the lump was ugly and the doc deemed it 'necessary' (meaning insurance would pay) I decided to go for it. I have a terrible case of white coat hypertension and when I went for the procedure my BP was through the roof and the anesthesiologist refused anesthesia based on that. Since my BP spike was stress related the GP prescribed metroprolol to control it next time. The first time I took it (without food, a big mistake) I had horrible pain in the same spots as before. I thought I better sleep in the living room so they would find the body sooner. Because I was sweating so bad I grabbed a glass of ice water. When I drank it I felt the sensation of coldness in the exact spots where the pain was. After a while I thought wouldn't an ulcer do that, so I drank some pepto bismol and the relief was immediate. The point of the story is that an ulcer presented symptoms that made the docs want to check my heart. A note on the metroprolol - without it my BP jumps from 115/68 at home to 130/80 at work; with it, it only rises to 125/75. I don't know if it's worth it to take it for that minor improvement. I've heard of statins blocking CoQ10. Where did you hear metroprolol does it too?

randian

Re: Had a scare today.

Post Number:#13  Post by randian » Mon Aug 05, 2013 10:46 pm

bbtri wrote:I've heard of statins blocking CoQ10. Where did you hear metroprolol does it too?

I read it here

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Re: Had a scare today.

Post Number:#14  Post by Johnwen » Tue Aug 06, 2013 10:18 am

Randian
On the metoprolol did they give you succinate or tartrate? Succinate is long lasting (er), Tartrate is fast acting.
All beta blockers slow the heart rate and weaken the contractions of the heart and all have similar side effects, one is stomach aches in about 10% of the people that take them.
Metformin is used to threat diabetes so you must have been spiking on your blood sugar also or there is some off label use they were trying to shoot for???
Did they do a chest X-ray when you went back this last time?
Is the pain on the right chest side in the upper part towards the shoulder or more towards the bottom near the bottom of the ribs, Is it towards the center of the chest or out towards the side?? Does it feel deep inside or is it towards the surface?? I’m trying to get a idea of the location of where the pain is to get a idea what could be causing it.
Sometimes, something as simple as a pulled muscle or bronchitis may seem like your falling apart and thoughts start snowballing and what if’s Take over and you go into fight or flight mode and then you turn into a real mess. Best advice at this point since you have already been to the doc’s is try to look at this as if it’s happening to someone else and your trying to see what the heck is going on. Kind of like I’m doing. But you have to keep a positive attitude, I know it hurts but your walking, talking and breathing so all you have to do is get rid of the source of the pain and you’ll be fine!! That’s what you pay the doc’s the big money for!!!!
To steal ideas from one person is plagiarism. To steal from many is
research!

randian

Re: Had a scare today.

Post Number:#15  Post by randian » Tue Aug 06, 2013 11:39 am

Johnwen wrote:On the metoprolol did they give you succinate or tartrate? Succinate is long lasting (er), Tartrate is fast acting.

succinate. I'm worried about the heart failure reputation this drug has and apparent prevention of CoQ10 production in the body.
Johnwen wrote:Metformin is used to threat diabetes so you must have been spiking on your blood sugar also or there is some off label use they were trying to shoot for???

Nope, type II diabetes. Glucose 260 after an involuntary (hours and hours in the ER after a sleepless night) fast.
Johnwen wrote:Did they do a chest X-ray when you went back this last time?

Yes, but I didn't see it. What should I ask about it?
Johnwen wrote:Is the pain on the right chest side in the upper part towards the shoulder or more towards the bottom near the bottom of the ribs, Is it towards the center of the chest or out towards the side??

Towards the side, about halfway between armpit and bottom of ribs. Also some mild pain and discomfort at the bottom of the sternum, general chest tightness, and lots of gut pressure and distension. The metformin probably isn't helping the gastrointestinal distress. Neither is the cephalexin.
Johnwen wrote:Does it feel deep inside or is it towards the surface?? I’m trying to get a idea of the location of where the pain is to get a idea what could be causing it.

Closer to the surface, I think.

The gastrointestinal distress and right side pain have both significantly, but not entirely, abated today. My gut isn't rock hard like it was yesterday. I'm trying to calm down my gut with probiotics, digestive enzymes, and Betaine HCL supplements.

If I do have some blockages and have to get angioplasty done, I'm seriously considering doing them without stents. Stents don't seem to improve total mortality, and while they halve the restenosis rate over no stents, the stents themselves seem to attract problems. And I've been religious about Pauling therapy the last couple of months. What do you think?

I also believe I'm functionally hypothyroid. The ER doc tested my TSH, probably because he thought my high heart rate was caused by hyperthyroid. It was ~4.5 in a top lab reference range of 4.8, when the recommendations I've seen say you're clinically hypo over 3.0. The doc didn't care though because it was "in range". Shortsighted I thought. Hypothyroid would explain a lot of things, as would nutritional deficiencies from malabsorption due to low stomach acid (also a known side effect of hypo).

I suspect finding a compliant doc willing to do comprehensive tests (and prescribe natural dessicated thyroid if necessary rather than levothyroxine) is going to be very hard.


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