Saturday, 25 May 2013

Bradycardia: When your heart goes, meh.


Bradycardia is a fancy word for a slow heart rate. Kind of rolls of the tongue, doesn't it. Sounds like a cool novelist name, The Heart of Meh, written by Brad Y. Cardia. Fantasy is my bet. There'd be swords and dragons, the main anti-hero would be kickarse but constantly foiled by her need to lie down every 5 minutes. Kinda hard to fight a dragon when you're comatosed on the ground. Though maybe she'd use it to play possum and come out fighting after the dragon had discounted the threat. Or maybe the novel would be 3 lines long as the hero suddenly keels over and becomes a dragon chew toy. That sounds more realistic. (I may be watching way too much Game of Thrones.)

Bradycardia is generally defined as a heart rate under 60. For me 50s aren't unusual, and I'm not usually all that symptomatic. A bit tired maybe but not worryingly so. But when I hit the 40s things start to become unpleasant. When those 40s persist or hit the 41-42 mark it becomes really unpleasant. Now I know that for some elite athletes 40s may be their natural resting heart rate. But lets face it I'm hardly an elite athlete. I'm pretty sure an elite athlete's eyelashs could beat me up and leave me whimpering on the ground, freely offering them my lunch money. Low 40s are simply not a fun place to be. I'm pretty sure I've hit less than 40 but I have learnt that my bp cuff wont register a heart under 40, which is kind of a bummer. I would like to know just how low it is dropping.

Bradycardia is getting the best of me at the moment. I've had it off and on over the years (my max hr of 88 bpm after 10mins on the reclining bike used to bemuse the staff, it also made exercising hard) but of late it has taken up residence in my chest and seems intent on staying. Even when getting IV fluids the last few weeks I was having drops into the 40's and 50s much to the consternation of the staff. Increased fluids in my veins should technically help my heart rate, but no. It's a fickle little turd that doesn't like to be told what to do and decided that it wouldn't play the game.

Last week those who follow on FB will know bradycardia hit hard. As in, collapse in the kitchen, scare the bejebus out of both me and my son, hard. I have to be honest and say I haven't felt that bad before. I could feel my body shutting down. I was ice cold and starting to feel confused. That is not a nice place to be and one to which I don't ever wish to return. The level of pain in my heart alone, is something I could do without. It's been a long time since my family has been worried about leaving me home alone. And even longer since I've been worried about being left home alone. That I haven't really picked up since that event is clear to everyone, including me, and that alone is a tad concerning.

The only precursor I can identify for last week's hijinx, 20 minutes of low level physio. And when I say low level I mean a couple of toe points and legs lifts. I did my final assessment which pretty much just confirmed my permanent status of completely knackered. But that's it.  But exertion, in any form, seems to be a trigger for my bradycardia. Every time within 30-40 minutes. Garden for 10 mins, bradycardia. Vacuum the house, bradycardia. A couple of pathetic toe points and leg lifts, bradycardia. I'm sure someone told me exercising was supposed to increase your heart rate. Even going out for coffee with Mr Grumpy and walking around for 10 minutes left me with a weak and thready pulse that went blah........blah........blahhhh. Usually it'll pass within an hour or so, but last week it was a few hours. And since then shorter periods, but more frequently. Fun times.

A quick look at the research and the treatment options for bradycardia are pretty limited. The top three choices are: 1) Treat the underlying cause. Bwahahaha. After years of extensive testing they still can't pinpoint the cause of my symptoms. 2) Stop all medications that can cause bradycardia. Done. No more metoprolol for me. Which of course means rebound migraines and shakes. But still the bradycardia persists. 3) A pacemaker. This option has come up in past discussions with my cardiologist but it is more of a last resort solution as it can't be undone. Do I want to go down that route? I'm still unsure. Although if what happened last week were to happen again I think I would do it. Plus, peace of mind for both me and the family would be good. Yet more fun discussions to have with my cardio.

So on that note and because I am absolutely knackered again.

Cheers
The elite athlete Michelle :)

14 comments:

  1. oh gawd, snap again reading this post. ive been off the bb for two weeks, due to low pulse. feels like my heart is sticking. ive caught a pulse of 36 on the bp machine, didn't feel so good. yet a lot of the time my pulse is in the 40s I don't feel to bad just tired. everyones different.

    ive got an echo planned for two weeks, as you know though that will not be of much help. im dreading the pacemaker talk. 4 years ago it was mentioned, as a last resort.

    take care of yourself michelle. this is a bugger of an illness to cope with. x

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  2. Gads, you crack me up. You should be a stand-up comedy gal (errr, probably, a lie-down comedy gal, thanks to the Brady....but that would for an interesting bit on stage, no?)
    I get the bradycardia as well, but usually as a sudden response to a run of tachycardia, which, like your bradycardia, comes on after a toe point, leg lift, or lifting a glasss of water to my lips.
    A pacemaker is the most common - here in da US - remedy for what you have. But, that means, you can't use a microwave anymore. Perish the thought! The cardiologist I saw last week said caffeine is now being pushed as the first line tx for those with pure bradycardia. I imagine caffeine causes migraines for you though...as it does for me.
    Michelle, you need to compile these blog postings into a book. You are a rare a talent as you are a rare medical mystery. And I love you for that!

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  3. you are hilarious. i've been having problems with bradycardia,too, and you've pinpointed it exactly - my heart is going 'meh'.

    i'm writing a post about bradycardia on my blog, hope you don't mind if i link to this.

    thanks.

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  4. Midodrine and flufrocortisone gave me some semblance of a life back after six years of being homebound with POTS n bradycardia n tachycardia both at different times and positions.

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    1. Glad you found a great combo and you have life back even if it's not quite the same as before. I had a bad reaction to Midodrine, but have been on fludrocortisone since 2007 and it's been great. The pacemaker has turned out to be the best treatments for me. It fixed my bradycardia issue. Now if only I could find something as effective for the rest of my symptoms. :)

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  5. I came to your blog today because I am going through some serious bradycardia today. 43 bpm. Thankfully, it doesn't get lower than that. I don't have a doctor at the moment who can help me out. Thank goodness for Google and your blog. You have such a refreshing sense of humor. As twisted as it sounds, so glad that I am not alone in this. Thank you for your humor. It definitely helped me today try and wade through it.

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    1. Bradycardia is horrible. I ended up with a pacemaker 2mths after I wrote this. Weird how quickly things can turn, though I hope that isn't the case for you and that you can find a doctor to help soon :)

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    2. How has it been for you since the pacemaker?

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  6. Am so glad to have found this post. I am now on 1.25mg Bisoprolol, the dose having being halved 6 weeks ago after a few rocky weeks I thought I was doing great with a resting heart rate in the 50s and 60s. The last 5 days it's been back down to the 40s, 41 when sleeping, and I feel knackered. I look fine can walk snout fine, and can climb stairs etc, however as soon as Insit my HR slows, I feel cold and don't want to get up again. My brain also feels foggy at times. Am unsure what to do as my house says I have to stay on the half dose and bring honest I am worried about what haporns to my BP

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    1. Hi Allyson. Sorry for the delay in reply but for some reason this didn't come up in my notifications. I'm so sorry you are dealing with this. It is really hard to deal with low heart rates as it impacts on your functioning so much. I hope your doctors can find a solution for you. I know some people who need some form of beta blocker to deal with tachycardia who also have a pacemaker to deal with the resultant bradycardia. It can be really hard to work out what to do when you need a beta blocker but it's effects are crushing your quality of life. Thinking of you and hoping that in between your post and me getting back to you that ysomeone has sorted this for you xx

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  7. I just found this page and I LOVE YOU! My heart too says, meh. My heart rate is regularly in the 30's, so these posts have made me realize my super human-ness. How have I been able to survive all this time? I must be a miracle...I have always suspected it...

    I think a pace maker may be in my future. All at the ripe 'ole age of 43. Sigh.

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    1. If it makes you feel better it all went pear-shaped a week after my 40th. Happy birthday here's a shiny new pacemaker for you ;) It does help though and I have no regrets. It's no cure for me, but not having such low hr all the time helps so much :)

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    2. I'm a 45 yr old carpenter. I've had bradycardia on and off for years with no real solution. Have a heart monitor now and going for another EKG soon. Been unable to work because of almost blacking out and then really tired. HR in upper 30s to 40s. Are they reluctant to give me a pacemaker?

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    3. Doctors are reluctant to put in pacemakers in younger people and it is usually seen as a last resort option. If you're symptomatic with low heart rate that's usually an impetus to think pacemaker. Although they do have to rule out a host of potential causes and decide exactly what the cause of your brady is before popping one in. I can commiserate and I hope your doctors can sort it out quickly for you. Bradycardia is debilitating. Nearly 4yrs later I have no regrets getting mine. The peace of mind if nothing else was worth it. I hope your doctors can find some answers soon.

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