Advice Wanted... (medical) UPDATE post 14

[Cliff Clavin]

Maybe you've got a serious case of air pollution going on at your house. Because you see, The World Health Organization Monitoring Survey of Trends and Determinants in Cardiovascular Disease (the "MONICA" survey) took place in Augsburg, in Southern Germany during the winter of 1984-1985.

Over 4,000 randomly selected adults participated, and received electrocardiograms to measure their resting heart rate, and donated blood samples to measure plasma viscosity. Electrocardiograms were administered again in 1987-1988.

In January 1985, an air pollution episode occurred throughout central Europe, with elevated concentrations of sulfur dioxide, total suspended particulates, and carbon monoxide.

During the air pollution episode, higher heart rates were observed for men and women, after adjusting for cardiovascular risk factors and weather.

An elevated resting heart rate is a risk factor for death and fatal heart disease, and may signal changes in the autonomic control of the heart, that might partially account for the adverse health effects observed in association with air pollution.

One hypothesis is that increased plasma viscosity might lead to constricted blood flow in the heart (ischemia), which can be fatal in people with severe coronary heart disease.

During the air pollution episode, increases in plasma viscosity were observed, and persisted after adjusting for other cardiovascular risk factors and weather.

German researcher Annette Peters, et al. conclude that "the increased plasma viscosity observed in these analyses of a cross-sectional survey might therefore represent a part of the pathophysiological chain linking high ambient air pollution to increased mortality and hospital admissions for cardiovascular diseases."

An alternate hypothesis is proposed by Professsor Anthony Seaton of the University of Aberdeen Medical School. He collected blood samples from 112 elderly people in two cities in the U.K. over an 18-month period, and examined various blood values in comparison to PM10 concentrations.

Based on the analysis, Seaton suggests that inhalation of some component of PM10 may cause sequestration of red blood cells, which may explain the cardiovascular effects reported in other studies.

So, my recommendation is that you move into a bubble. Barring that, you should head on down to Cheers and have yourself a beer. Though maybe not. The air pollution can be pretty high down here on any given night also.

Cheers!

 

[MaryAnnDVC]

I called my doctor, the advice nurse who again asked my doctor and the echo department they all said no meds. My doctor is a very young doctor 27, maybe I'm too complicated of a patient for him. He is in IM no real speciality.

You have a 27 year old doctor?? Is he still doing his residency? Unless his name is Doogie Howser, you need to find yourself a grownup!

Hope you're feeling better! I was very dehydrated once...not pleasant, and can be very serious. Take care of yourself.

 

[Mskanga]

I would be looking for another doctor PRONTO. I had an EKG and an ECG last year , neither one of the times I was told not to take meds. This is not something to play with , if I was you my butt would be in the ER.

 

[icebrat001]

Feeling a little better. No longer faint, just really really tired. I was going to try and go to work today, but I didn't make it that far, oh well.

Yes my doctor is 27. He graduated HS early, finished undergrad in 3 years, then did med school and residency.

 

[ilovepcot]

Your condition worries me and I don't know how to help you. I sincerely wish you'd seek another medical opinion. You deserve the help I'm afraid you're not getting.

 

[Doesney]

You poor thing you are always so sick. Maybe it's not all physical.

 

[Kitty 34]

I sure hope you're feeling better or got a good second opinion.

 

[marymrg]

Why aren't they treating your dehydration? If that's all that they think is causing your increased heart rate, the first step would be IV fluids. I would present myself to an ER despite what your primary is telling you.

 

[phorsenuf]

I agree, I wouldn't care what my Dr said. If I was that sick I would be heading for the ER. Being a med student I'm suprised you haven't been yet. Surely you must know those are some serious symptoms.

Good luck and I hope everything turns out OK with you. But get thee to an ER!!!!

 

[poohandwendy]

I have read more than one post of yours regarding cardiac issues and doctors you feel are not taking your health issues seriously.

At this point, I am just wondering why you are not educating yourself? You seem to be an intelligent person and you have the internet at your fingertips...why aren't you arming yourself with knowledge before you actually step into your doctors office?

It does not take a medical degree to know that a resting heart rate of 161, dehydration, a body temp of 94 and high blood pressure reading are all abnormal and suggest immediate admittance to a hospital for hydration and further testing. Btw, once you were admitted they can do an echo in the hospital, at any time...meds or no meds. It's not like you are in the sticks, you are in the san francisco bay area.

Frankly, I am not sure I believe that is what happened, or that you have your info correct. If it is true, why on earth would an intelligent woman (one with a history of 2 heart attacks and planning on med school in te future) not seek a second medical opinion, preferrably at the nearest ER?

I have had heart rhythm issues in the past, they are minimal now. Had an echo, an ablation, along with a plethora of other tests, medications etc...the very first thing I did was arm myself with information so that I knew what the doctors were taking about and knew how to make decisions regarding my health.

I suggest you do the same and I wish you luck.

 

[phorsenuf]

I have read more than one post of yours regarding cardiac issues and doctors you feel are not taking your health issues seriously.

At this point, I am just wondering why you are not educating yourself? You seem to be an intelligent person and you have the internet at your fingertips...why aren't you arming yourself with knowledge before you actually step into your doctors office?

It does not take a medical degree to know that a resting heart rate of 161, dehydration, a body temp of 94 and high blood pressure reading are all abnormal and suggest immediate admittance to a hospital for hydration and further testing. Btw, once you were admitted they can do an echo in the hospital, at any time...meds or no meds. It's not like you are in the sticks, you are in the san francisco bay area.

Frankly, I am not sure I believe that is what happened, or that you have your info correct. If it is true, why on earth would an intelligent woman (one with a history of 2 heart attacks and planning on med school in te future) not seek a second medical opinion, preferrably at the nearest ER?

I have had heart rhythm issues in the past, they are minimal now. Had an echo, an ablation, along with a plethora of other tests, medications etc...the very first thing I did was arm myself with information so that I knew what the doctors were taking about and knew how to make decisions regarding my health.

I suggest you do the same and I wish you luck.

Excellant post!

 

[poohandwendy]

It took 6 weeks to get my echo appointment and he really wants the test done, I can't take meds because it can affect the test results.

I am confused. Just a month ago, you posted that you already had an echo and it was normal.

(posted 2/26/06)They only send you to a cardiologist (who would order that test) if your EKG and Echo come out strange and they look normal. So I guess I won't be seeing one.

So, why the urgency now...to the point where a doctor would suggest not taking medication to reduce a high fever to repeat an echo that was normal? Not only that, the doctor knows that if you are admitted, he can order an echo in the hospital...not that he would even need to order another echo because the first one was normal....none of this makes any sense at all.

 

[Tigger_Magic]

P&W, you are not alone in being confused. This doesn't seem to add up.

 

[poohandwendy]

P&W, you are not alone in being confused. This doesn't seem to add up.

No, it doesn't.

 

[CheshireVal]

None of this sounds right to me, either. I went through a period in my early 20s where I was having constant heart palpitations and chest pain. BP was also abnormally high. I was admitted into the hospital overnight for testing. Since then, I've had several EKGs and Echos for recurring high BP and have never had to withhold medicine.

(However... I did have a stress test where they wouldn't let me eat or drink beforehand.)

 

[poohandwendy]

Just wanted to comment on the previous 'heart attacks'. It just does not add up that you had two (2) heart attacks and none of the tests you have had (ecgs and echo) are coming up abnormal. By definition, a heart attack (myocardial infarction) means damage to the heart muscle. Perhaps with one small (for lack of better word) heart attack, it would be hard to find the damage...but two?

Sounds to me that you are using the wrong term. Maybe you had anxiety attacks, or rhthym problems tha caused an 'attack' (with your history, that would make total sense) or angina or something. But it just does not sound like you actually had two heart attacks. Maybe The Lion King or another medical professional could add their 2 cents?

And you say that you had the first heart attack when you were graduating boot camp in one branch of service and then the other when you were graduating boot camp in another branch of service. How on earth did you get enlisted in the second branch after having a heart attack while enlisted? I mean, you are only 23 yo, that sure is alot of heart issues in a short period of time, in two different branches. Maybe someone else can clarify, but I would think that would make you medically ineligible to enlist?

 

[phorsenuf]

If I recall correctly there is a waiting period before you can reenlist and then I believe you have to go before a med board? I was discharged long long ago (during boot camp too) for a knee injury. I remember some time after going to see an Air Force recruiter and it didn't seem that easy to get back in after a medical problem. I would assume if you've had a heart attack, especially at such a young age, that would immediatly disqualify you.

My DS had to get all kinds of waivers to get into the army because he had sustained 2 broken legs at the age of 16. He was 100% with no disability according to our orthopedic Dr, but he still had to jump through hoops to get in.

 

[poohandwendy]

Originally Posted by icebrat001:
Yep that's right. I had heart attacks while in the miltary, 1 day prior to graduation in the Navy and then again on graduation day in the Army.

Well, I just looked it up. You would not have been eligible to enlist in the Army with your previous heart condition, even if it were not a heart attack. Just your resting heart rate would have deemed you ineligible.

The disqualifying medical conditions are listed below. The International Classification of Disease (ICD) codes are listed in parentheses following each standard.

The causes for rejection for appointment, enlistment, and induction are:

a. All valvular heart diseases, congenital (746) or acquired (394), including those improved by surgery except mitral valve prolapse and bicuspid aortic valve. These latter two conditions are not reasons for rejection unless there is associated tachyarrhythmia, mitral regurgitation, aortic stenosis, insufficiency, or cardiomegaly.

b. Coronary heart disease (410).

c. Symptomatic arrhythmia (or electrocardiographic evidence of arrhythmia), history of.

(1) Supraventricular tachycardia (427.0), or any dysrhythmia originating from the atrium or sinoatrial node, such as atrial flutter, and atrial fibrillation, unless there has been no recurrence during the preceding 2 years while off all medications. Premature atrial or ventricular contractions are disqualifying when sufficiently symptomatic to require treatment or result in physical or psychological impairment.

(2) Ventricular arrhythmias (427.1), ncluding ventricul arfibrillation, tachycardia, and multifocal premature ventricular contractions. Occasional asymptomatic premature ventricular contractions are not disqualifying.

(3) Ventricular conduction disorders, left bundle branch block (426.2), Mobitz type II second degree atrioventricular (AV) block (426.12), and third degree AV block (426.0). Wolff-Parkinson-White Syndrome (426.7) and Lown- Ganong-Levine-Syndrome (426.81) associated with an arrhythmia are also disqualifying.

(4) Conduction disturbances such as first degree AV block (426.11), left anterior hemiblock (426.2), right bundle branch block (426.4), or Mobitz type I second degree AV block (426.13) are disqualifying when symptomatic or associated with underlying cardiovascular disease.

d. Hypertrophy or dilatation of the heart (429.3).

e. Cardiomyopathy (425), including myocarditis (422), or history of congestive heart failure (428) even though currently compensated.

f. Pericarditis (420).

g. Persistent tachycardia (785) (resting pulse rate of 100 or greater).

h. Congenital anomalies of heart and great vessels (746), except for corrected patent ductus arteriosus.

 

[Tigger_Magic]

It doesn't make sense to me with all the symptoms the OP had/has (temp of 94, BP high, pulse of 161, dehydrated, shortness of breath, feeling faint, etc.) that the doctor doesn't send them to the ER, but instead sends them home, where they find enough strength to post repeatedly on this thread... until now.

 

[poohandwendy]

I want to know what kind of game the OP is playing. Heart issues are serious (for those of us who have dealt with them) and I don't think it is remotely amusing to make up stories about your health.