I need feedback-

[Christina L]

Hi everyone,

Last night I wore a pulse oxygenation monitor/heart rate monitor to bed. You know me, I didn't get hardly any sleep as I kept looking at the readings on the monitor.

When I first put it on last night - just a clip on my index finger on my left hand with the monitor attached to that (very small) - most of you know what these are like - anyway, when I first put it on, I decided I'm not going to look at it and go to sleep! In my dreams!! Ha.

My heart rate got as low as 47!!!! It hovered around the low to mid 50s supine but as soon as I would get up, it would go into the 60s sometimes 70s. My pulse ox showed at its lowest 88% and hovered around 90%. Mind you this was when I was awake supine. I have no idea how low everything went after I had taken an Ativan and a Benadryl to get to sleep - I was so wired and nervous - JUST like when I was in the hospital watching my monitor all the time. Of course here I didn't have a nurse to wheel the monitor out of the room so I wouldn't look at it every minute!

Wayne is out of town on business, otherwise he wouldn't have slept any last night either.

What is considered desaturating enough to require oxygen at night? This morning I put the monitor on only for a few minutes and the saturation stayed at 95% and the heart rate was in the 60s to low 70s. I think, though if I were to sit and say read the paper, my heart rate would go down into the 50s.

I feel my heart rate is awfully low (?). It is kind of scary. I noticed during the night when I would get short of breath, my heart rate would be at its lowest. Of course, I think I was hyperventilating also.

I may drive down to a lower elevation today with the monitor to see what it shows. Remember we live at 7700 feet and I have read that there is about 30% less oxygen at this elevation.

My PCP is the one who decided to do the monitor - he, however, thinks that if I am desaturating (or having sleep apnea) that I would still have it at a lower elevation and would just need to wear oxygen to sleep.

I welcome all opinions on this matter. Thanks.

Christina L

 

[Christina L]

Mark,

Mark,

My heart rate was very, very low right after my surgery and my BP also - my HR was dipping down into the 30s and that is when they took me back to the ICU and contemplated putting a permanent pacemaker in. When I wore a monitor to exercise here at home the few months following surgery, my heart rate was always low then also - especially at rest.

I wore the monitor to check for sleep apnea. When I got on the internet after I found out I possibly had right heart enlargement, sleep apnea can be a cause of that and also living at high altitudes. I asked my PCP about it and he was not hesitant at all to prescribe me the monitor.

I do not check my own heart rate against the monitor - just feel that the monitor is probably right. I know I have a low heart rate but when I go to the doc's office it usually is in the upper 60s or 70s and my BP is usually around 115/75-80.

Yes, I am obsessing and ever since I was told I had "right heart enlargement" I can feel every possible symptom and I am also very depressed right now.

My exercise tolerance is good - no SOB BUT I do have very strong PACs while adjusting to exercise which I have only noticed in the last year.

As for the sleep apnea being a possibility, I do wake up "tired" and do not feel totally refreshed, which is a sign of SA. I do snore also.

If I were to have another echo and it showed NO right heart enlargement and everything normal, I would feel like my old self in an instant. My thoughts and obsessing are what do me in (as per Ross).

Christina L

 

[geebee]

A couple of things to consider. One, everyone's HR & BP drop when they are resting and lying down. Our bodies simply do not need as much blood pumping through it when we are supine. Our HP & BP rise as we do to make sure the blood gets to the extremities (such as the brain) so we do not pass out.

I often find when I get up during the night to pee (gotta love that lasix - no matter when you take it, it always seems to activate itself at night), when I return to bed, I get night sweats big time. I attribute those to the rise in BP & HR and my body being confused when I ask it to slow back down again. I think it gets confused.

When we monitor monitors, we get all kinds of crazy responses. That is because we get panicky when we see readings we don't like which causes HR & BP reactions to our reactions. Hope this makes some sense.

If the readings are being recorded, you need to just ignore them and let the doctor decide what is going on. I don't agree that where you live makes that much difference especially when resting. It is possible that activity may be more difficult and take more energy but resting should not be affected. There is plenty of oxygen at 7700 feet to breathe (unless you were very, very ill).

I understand where you are coming from tho. You have symptoms that are disturbing and merely want to find out what is wrong. You have to try and relax along the way of this journey of discovery or you will not make it to the end sane.

Hope this helped a little.

 

[Christina L]

Thanks Gina -

Thanks Gina -

What I am wondering, though, is do MOST people's heart rates get that low at night??

A big joke a few years back with Wayne and I - I would always say that "when" I got very old, I wanted to be pleasantly and happily confused (senile) and Wayne would always retort "You're on your way!"

I am definitely on my way to the insane asylum if I keep this up. I am trying-trying. I am on Prozac and it worked at first, but now I am wondering if it is only making my thought processes worse. I do best when I am up and about during the day - keeping myself busy, but my heart is on my mind right now 24/7 and that is no way to live. I feel as if I am a walking bundle of nerves.

Christina L

 

[Christina L]

P.s.

P.s.

A person CAN desaturate while sleeping - meaning they are not getting enough oxygen - they wear a CPAP (continuous positive airway pressure) machine (oxygen basically) to help with this. It doesn't matter if the person lives at a high elevation or a low - it is just something that happens to some people and probably people with heart problems more so than most.

My counselor's brother died in his sleep of sleep apnea - he was a big, big guy, though and they didn't know he had sleep apnea.

I just couldn't take what my cardio said "see you in a year" and "if you get a-fib, we will just put you on Coumadin and you'll be fine" - and live with that. I have to know what is causing this (if anything and if I really have right heart enlargement to begin with) and to feel that I can do something about it. I will never make it through the next year until my next echo, unless I take some action myself.

Christina L

 

[tobagotwo]

People do generally have slower heartbeats at night. Mine usually gets into the low 50s as well, which is fine. It goes up during the day, because it's a reactive organ, and I need more blood pumped during the day to perform my activities. But the heart needs to rest at night, too, just like the rest of you.

One thing to keep in mind is that a monitor is supposed to try to measure you under fairly normal conditions. That would mean that you should avoid taking drugs to fall asleep, as they can negatively affect the outcome by mildly depressing your breathing.

Take nothing but your prescribed medications, if at all possible. Take them at your normal times. Don't change your routines. If you don't often dive down into the thicker air, then don't do it while you're trying to learn how your body normally reacts to its environment. If you keep playing razzle-dazzle with the monitor, its results will be meaningless (or worse, misleading).

Try to divert your attention to something else. And perhaps put some tape over the LCD screen to thwart your curiosity. You can get the results when it's done.

Best wishes,

 

[Cris N]

Don't ya just love monitors? - they'll drive you crazy. I would bet that one reason for your low sat was your anxiety level. But rather than put you on a monitor I wonder why you aren't setting up a sleep study. This would definitively determine if you have sleep apnea- if you do, then you would be well on your way to treatment. Trying to sleep with a monitor (& drugs) will drive you crazy! You've been through a lot of anxiety lately - it seems to me that your watching your own oxygen level and heart rate (50s at rest sounds reasonable to me) is not the most effective way to make a diagnosis.

Cris

 

[susieq14]

(((((((((((((((Christina)))))))))))))))))))))))))

I have absolutely nothing to offer you since I'm very new at all this but I did want to offer you a big hug as you try to deal with your fears and concerns.

I have lots of concerns myself with my new diagnosis of MR and a cardiologist who says not to worry so I can understand exactly how you must feel. I need to sort out my thoughts and post a message soon to get some input from all the experts here.

Take Care and I hope you get a restful sleep tonite to make up for last nite!

Sue

 

[Christina L]

Thanks everyone for your

Thanks everyone for your

responses. My heart rate is in the 50s at rest while I am awake - the upper 50s and then can go into the low 60s. Is that too low?

Anyway, I did what you all said to NOT do - I took the monitor down the mountain canyon to 4800 feet sea level. My sats down there were around 98% - when I came out of the Target store, my sat was 99% (I didn't wear the monitor into the store). I'm neurotic but not that bad.

When I came back up the canyon, my sats started dropping and averaged 93% when I got to Estes. When I got in the house after carrying bags of groceries in, I put the monitor on again and my sat was 97%.

Again last night while in bed, my sats were around 90% and I saw they dropped as low as 88% at one point, but when I fell asleep with the medicine, I have no idea what my sats dropped to.

So.....

As for the medication, Bob, I had always taken one Benadryl at night before bed - told people it made me sleep like a "rock" - well, maybe that is the problem - maybe I was morphed into a "rock" while asleep and it has put a strain on my heart. When I read up on right heart dilation and sleep apnea, I read that drinking alcohol or taking sleep aids will only worsen the sleep apnea, so I quit the Benadryl about a month ago and believe it or not, can get to sleep just fine - it is just that I wake up in the night now - the Prozac is responsible for that also.

I could not get back to sleep at all last night. I went to bed around midnight - woke totally up at 3 after having half-slept with the monitor on - then was wired totally. I HAD to take something to get to sleep as I was a wreck - I also thought that half the night with the monitor without Benadryl and half the night with, might tell them something.

I am not sure how these monitors work, but I am going to have to document how many times I have turned this thing on and off. Hope I will not be in trouble for what I have done and have to do the test over again through the night.

I am wondering what a "normal" oxygen saturation should be say at 2000 feet elevation. I told Wayne I wish he would have been here. I would have put the monitor on him!! That probably would have really freaked me out if his oxygen sat was 100% and mine was so low. I know when I was doing cardiac rehab up here in Estes Park right after my surgery, my oxygen sat after exercise was around 94% and the nurse said that was "normal" for this elevation.

Christina L

 

[Christina L]

Cris and Sue -

Cris and Sue -

thanks for your empathy and well wishes. I just think I am too honest with my feelings a lot of times - wear my heart on my sleeve.

Cris, the next step will be a formal sleep study if this monitor shows anything troublesome.

How does one get past this worry and fear? - it feeds itself, I know - that is what my counselor told me.

I am still waiting to hear from Cleveland regarding my echo tape that I had sent to them. If they say only good things, do you think I will believe THEM? That is the million dollar question. Marty here on VR.com was nice enough to review my echo reports (not the tape, the written report) and he said I am "fine" and to worry about how to get our troops out of Iraq. Thanks again, Marty, for your help.

Christina L

 

[Granbonny]

Christina

Christina

I know that my across the street neighbor sleeps with a CPAP machine at night.He had a mild heart attack several years ago..and open -heart surgery for4 by-passes a year ago..and still sleeps with one....They are very private people..so, I don't ask too many questions........I would have never known, but she was giving me a tour of their home and I noticed it by his side of bed..and of course, I asked what it was. .....I know, when I have had a very stressful day..I take a Tylenol PM..50 mg. of benedryl..and fall right asleep. ..........Bonnie

 

[perkicar]

Christina,
It's not unusual for your sats to drop if you are sleeping very soundly, as in your heart rate dropping too. We have to be careful with our patients sometimes because they get too comfy and desat because they aren't breathing as much. I'd suspect the combo of benedryl and ativan (are you taking .5 or 1.0 mg?) would do a good job of making you pretty sleepy. I had a patient ask for phenergan the other day going to MRI, after I'd given her her full hour's dose of fentanyl--asked the MRI folks to put her on a sat monitor to make sure she was breathing enough LOL.
Sounds like your heart rate is low normally--and what you are seeing is "normal" for you.
Try not to obsess about it!
Carolyn

 

[Tony]

My sitting BP is around 50. The other night it was 44 while lying in bed.

This was normal for me pre-surgury. It is now the same with the help of Lopressor.

My cardio is satisfied with it.

 

[MelissaM]

Hey Chris,

The heartrate thing is as personal as the individual. There are monks and yogis who can bring their heart rates very low. I don't think there is anything inherently wrong with a low heartrate. Taking Ativan/Benydryl together seems like it could be a recipe for a low heart rate.

Now. . ..as for the obsessive thoughts, perhaps the first three of the twelve steps can help you. . .?

1) Admit you are powerless over your thoughts - that your thoughts have unmanageable
2) Come to believe that a Power greater than yourself can restore you to sanity
3) Make a decision to turn your will and your thoughts over to the care of God as you understand God

Melissa

 

[twinmaker]

Christina, when was your last echo? If getting another would alleviate some of your worry, could you ask your doctor to perform one? It's non-invasive and I'm for anything that will help with anxiety. I take a low dose of Effexor XR everyday and it really helps me. Of course, I usually worry about silly things that are not heart related. My psychiatrist told me that I do that instead of worry about all my heart problems. Maybe that's transference? Anyway,as far as your low heart rate... I had atrial fib and my heart rate would go down into the high 30's and low 40's. I wore an event recorder for a month. If I remember correctly, a lot of those episodes were in the evening and at night. Anyway, they talked about a pacemaker and I finally had an A-V node ablation which required that I have a pacemaker implanted. Having the permanant pacer sure made me feel better. I mean...you feel pretty yucky when your heart rate is low. I know our heart problems are different but the pacemaker really helped. Anyway, it's seems like it's always something with a lot of us. When my electrophysilogist told me a year and a half ago that I had ventricular tachycardia (found on the feedback from my pacemaker) and was at risk for sudden cardiac death and that I would need a defibrillator, I nearly fell off the exam table. No wonder some of us are obsessive when it comes to our heart conditions. But I do believe that God is in control and when I get to a certain point, I turn it all over to Him. I know that I should do that before I start to worry and that is something that I've been praying about and working on for a long time. Anyway, friend, I know where you are coming from and can relate. I will pray for you to arrive at some peace where this is all concerned. Linda

 

[Christina L]

Thank you everyone -

Thank you everyone -

I had my wine earlier, Mark - a small glass of pinot noir, with my turkey, low-salt chili that I made. I did watch Desparate Housewives as I told you I was going to - a respite from MY worries for an hour.

Bonnie, is the CPAP machine a huge contraption?? There are a LOT of people that use them - I transcribe reports on this all the time.

Linda, your words were so sweet. Believe me, I have cried out to God in the scary hours of the night - hoping that He/She would send a bolt of lightning or something to snap me out of this, but no such luck (yet). I have also thought of getting another echo, BUT what if it showed the same thing - in a way I would rather "believe" that the echo was wrong for now and pray that next year the echo will be normal.

Carolyn, I took one Benadryl before bedtime ever since my surgery - no Ativan - only in the first few months following my surgery did I also take Ativan with the Benadryl. I was just prescribed ten measly Ativan from my PCP - he won't give me any more than that because they are addictive. How stupid is that??? Ativan is for anxiety and I am a person with a medical condition that is scaring me to death! Anyway, I will be calling my PCP about getting more Ativan this week. I am suspecting that taking that one Benadryl every night may not have been a good thing. I have stopped the practice - only took one last night (and the Ativan) so I could get a little sleep.

I have been on Prozac for three weeks now and know that it probably has not kicked in fully yet.

Tony, do you mean your heart rate is 50 at rest - you said your BP (blood pressure)? Does it make you tired? I'm happy to hear that your cardio is okay with that - must mean it is okay.

Melissa, you are right - there are yogi's who have very low heart rates - I would like to compare myself to Lance Armstrong who supposedly has a resting heart rate in the 40s (?). However, I don't think he and I have low heart rates for the same reasons.

Mark, you are so, so right. Our minds are powerful. I felt perfectly fine before my echo and ever since, I feel every little twinge in my heart, am more short of breath than ever before and can literally feel my heart enlarging. I know - I know - what I believe could very well come true. I HAVE to change my thought process. It is going to take Cleveland or my new cardio in January explaining things out in detail - that this is not anything to worry about - like I have been told already but can't get past the "dilated heart" part of the diagnosis.

I covet all prayers and I will do the same for everyone here. Melissa - thank you for the first three of the 12-steps. Always a good reminder and very true. Hope you are enjoying the holiday season in Boulder.

You're all gems - get a great night's sleep. I know I will tonight without that darned monitor on.

Christina L

 

[BDMc]

Heart Rate?

Heart Rate?

Christina, I don't have the answers you are looking for, but am really sorry you are ahving such a hard time. I would've thought your heart rate would be high at that altitude. But I don't know squat about this stuff. Hope you are feeling better soon. Brian

 

[Mb]

Dear Christine:

My husband also has right sided heart enlargement. He has dual St. Jude Valves, and chronic a-fib. Would you like to send me a copy of your report so that I can compare them?

He also suffers sometimes from anxiety. I had to take him to the ER about 5 weeks ago, as his HR and BP were so elevated, that he was truly sick, and suffered angina for the very first time. The Dr. gave his a script for ativan, and yes, for him it does help a lot. He also was scripted for an increase in his beta blocker. And that, my friend, has made all of the difference in the world.

I hear your aniety. I think you actually could be traumatized by all of this, and you truly need to get it "fixed"......for both your mental and physical health.

My husband also has a very very low heart rate at times. When he was in the hospital, AWAKE, it went as low as in the 30's......his "normal is high 50's, on the beta blocker.
He also has suffered from sleep apnea. Of course, he doesn't know it.....I do. Scares me silly when it happens.

Please send me your info. I'd be happy to compare them to my husbands right sided heart enlargement.

Marybeth

 

[Christina L]

I'm also sorry to hear about your

I'm also sorry to hear about your

husband's problems, MaryBeth. At least his doctor will prescribe him with Ativan. I will be calling my PCP today to ask about being given some more Ativan. I just don't understand their reasoning. Stress is very hard on the heart and to not be given a medication that will help with the stress...it doesn't make sense.

I think I will pass on comparing the echos as Mark has suggested. It really would only lead to trouble for ME. Thanks for the offer. I really appreciate your trying to help, MaryBeth. Also I am curious as to why your husband isn't on a CPAP machine (?). Sleep apnea is life-threatening from what I have read.

The cardio who gave me the second opinion after the not-so-great echo, told me that my heart has always been upper limits of normal and it is from years of regurgitation and that sometimes after surgery it will enlarge a bit. I have wondered that also - if now having a mitral valve that is really pushing the blood through - if my heart is just trying to adjust. I like to think of it that way.

ALSO, the echo could have been wrong. I see a new cardio on January 4. He may suggest getting another echo and I may need to ask for one for my own peace of mind, but there again I am afraid of getting the same results from another echo.

I slept through the night totally last night - the first time in a month - and I had the help of no sleeping aids.

This (see below) was sent out by my work this morning - they send a motivational E-mail out every Monday - is this not appropriate for me at this time?
----------------------------------------------

Thoughts pointing the way
What you think influences what you see. What you think influences what you do.
What you think influences what you learn. What you think influences how you feel.

What you think has an enormous impact on the way you experience life. What you think determines the very nature of the world you create for yourself.

Thoughts have no physical mass, yet they do indeed have power. And there are no restraints or limitations upon what you can think.

Consider all the many places to which your thoughts have carried you. Imagine the limitless possibilities of where your thoughts can now enable you to go.

Choose positive, creative, loving, life-affirming thoughts. And with those thoughts pointing the way, you can fill your world with value.

-- Ralph Marston
--------------------------------
Thanks again everyone for your help. Have a good day.

Christina L.

 

[Marguerite53]

Hi Christina. I'm glad to hear that you are working hard to understand yourself and your condition. I think it's great that you are testing your oxygen saturation. I think you can probalby really educate many of us as you walk through this latest round of tests. So please keep posting.

Personally, though, I would probably pose all of my questions and concerns to a tech or nurse. I have found that they are wonderfully helpful and willing to talk if you find the right ones. I've learned far more from my echo techs than my cardio about the heart!! Some are just very very willing to talk with you. I would really try to avoid too much second guessing. Experimenting by going down in elevation was a great idea, I think. Take those numbers in to someone who can make sense of them! But, once you have asked them......you have to believe their answer!! I think you are having trouble coming to terms with their answers so you keep questioning things. Find someone whose demeanor and attention and intelligence you can trust. Then trust them!

I was on an event monitor last month because I felt lousy one day and went over to my cute little snazzy BP machine that I bought (for way too much $ because of all the neat bells and whistles on it) to see if it were blood pressure realted. Well, my pulse was 46!! That seemed way low (especially since I'd just been dancing around the house!) I reported it to a very very helpful nurse and then got the event monitor. What turned out to be the case was that because I have PVC's (similar to your PAC's? arythmmias, anyway) my PB monitor could not accurately read my pulse, it was throwing off my "sophisticated" little machine.

I'm sure your monitor is able to detect those variations, but I thought I would mention that anyway. Kind of a simple explanation for the low number, for me anyway.

Another thing I wanted to mention to you was that I had a very odd but simple "fix" to some weird problems I was having. I started taking calcium. I'm much older than you at 51, but these problems occured when I was most stressed out with little kids, little sleep, husband in high stress job, major house repairs, etc etc. I also became lactose intolerant and was off many milk products. My symptoms were bizarre. Muscle twitches everywhere, total anxiety to the point of tremors - couldn't drive on the freeway, fear of other unreasonably simple things. I'd get little images in the corner of my eyes and think someone was behind me all the time. paranoia. Stomach problems. Waking at the slightest sound. I was a mess! Afraid of everything! When I went on a Calcium supplement (after a blood test showed I was low) my whole world changed. It is such a relief to be without those feelings. And truly, it's the calcium! Just calmed me right down and got my head all level again!! I suspect you've had lots of bloodwork done, and I would think this would have popped up for you, but I just wanted to mention it. (and, in fact, I may have mentioned it to you before)

Anyway. Good luck with everything. Oh, and my husband had a sleep study done. It was very helpful. He ended up having some minor throat surgery which helped enormously at first, but now that he's kind of overweight, the snoring is back, but not the apnea. I'm very very glad that he went in for the sleep study. Perhaps that is a good next step for you.

Keep us posted!

Marguerite