my own concierge

I feel as if I have my own concierge PM patient team where 24 hours a day 7 days a week I can post questions and look for the answers. Todays quiz. Waking up is good but after I am awake I feel as if I am an old fashioned crank car because my heart appears to be searching for the starter spark This AM my oxymeter pulse machine read 33 at first, then 78 then 101 and on and on. Finally, like now it is regular at 68. I this a common occurrence? I guess once I know that what is happening is not unusual, I can begin to accept.
Also when you are at daily activities and become aware of the irregular beat be it palpitations, racing heart whatever, do you just ignore and proceed with what you were doing. Do you just continue on with your exercise class Tracey? I guess the answers to this particular question is important because I hope to be able to plan vacations. Frank, when you are driving your 360 mile trip, what do you do when an episode strikes.
Will be looking forward to any responses. Thank you.

4 Comments

Wondered about your name

by magenniskeith - 2013-04-08 03:04:20

tYour Angry Sparrow name has made me wonder about you. Now I know the connotation it had for me was a false picture..... more like an avenging hawk, determined finally to overcome every mishap. Much to be desired. You are probably are right about my checking signs too much. It is just that when I feel good, I want to assure myself that this is how I can be feeling when all is well, and when I feel lousy I just want to make sure something IS happening and that it is not all in my mind. I have had my share of problems, mastectomy, hysterectomy, open heart surgery, automobile accident and the death of my son. I like to think of myself as an independent woman who is grateful for all that I have but HATES having to be dependent on others for rides etc. I guess the best way to not be dependent is to take your advice and try to ignore the fluctuations of the heart.

Good reply.....

by donr - 2013-04-08 03:04:28

.....oh, irritated small bird!

If she is talking about one of those pulse oxymeters that you clip on over a finger, they can be erratic as all getout if you have certain arrhythmias.

I had some experience this past Jan while I was doing a cardiac rehab session. The Physical therapist frequently monitored my body for HR, O2 saturation & BP. I had warned him that I was the local PVC king, so don't be surprised at anything. He said "OK" & preceded. We had no end of fun watching the Oxymeter go through its paces. Since it depends on light reflecting off of the blood under the fingernail, that was no big deal - it was nice & steady & dependable.

Ah, but it depended on some other method of determining HR. I suspect that it sensed the increase in pressure in the tip of my finger to count heart beats - & therein lies a problem. If the heart was having frequent PVC's, the premature beats were not strong enough to be sensed, so did not get counted. The Oxymeter determines HR by the elapsed time for a single beat & cxonverts that elapsed time into an equivalent HR. F'rinstance, if it senses a full second for the elapsed time between beats, it converts that into a HR of 60 BPM. Suppose it sensed a full TWO seconds elapsed time for a beat - that converts into 30 BPM. If it measured 1/2 second elapsed time, it converts into 120 BPM. So if your heart beats irregularly, it gets confused - you think - & shows continually changing HR's.

Most likely, the 38 was an indication of a single PVC that it did not sense & it really represented a HR of 76 BPM (twice the rate it showed because it measured the elapsed time for TWO beats, not one.). The 101 was probably accurate, also, representing either anxiety induced increased HR due to seeing fluctuating HR's or activity of getting up & moving about causing a truly increased HR.

It is not unusual for HR to be much slower while you are asleep than when awake - that's why we rarely function at long periods of time at the lower limit of our PM - we only go there when we sleep! During our waking hours, our pulse is all over the map, depending upon our level of activity, excitement or fear. For example: You are sitting in a rocking chair oj the front stoop, gently rocking & relaxed, mind shifted into neutral, thinking of nothing. Your HR would be pretty low. The urge to purge hits you & you get up to head for the facility - your HR increases when you stand up & start walking; you get to the door w/ the crescent moon cut in it (Goes along w/ the crank started car & searching for the correct spark) & open it; there on the floor behind the porcelein throne is a coiled up rattlesnake; Your adrenal gland gives you a shot big enough to stun an elephant & you let out a blood curdling scream & pass a terrified antelope at full speed. Think where your HR is then!!!!! (That is an example of an event that happened to my mother in Miami, FLA when I was in 6th grade)

Remember that an Oxymeter can jump all over the place rapidly because it calculates a HR corresponding to EVERY beat.

I second the idea by Sparrow about over monitoring vital signs. I was once upon a time, in a galaxy far away doing my BP three times a day - because my GP had me doing it. I got my PM & told my cardio that I was NOT going to do that any longer. Checking my BP caused me more stress & anxiety than living in ignorance. Besides, it was reasonably stable at a safe level.

Just go by how you feel. Numbers from machines can become self-fullfilling prophesies.

Cheers! Don

Love your stories.

by magenniskeith - 2013-04-08 04:04:12

Don, I would love to match your stories with some of mine, my analogies to yours, but yours are really more fun. All makes sense. Right now I FEEL GOOD, and intend to feel that way the rest of today. No more machines today. The sun is shining, the dog is barking,,,,,so I have to shut her up. Have a good peanut picking day.

Mag

by Grateful Heart - 2013-04-08 10:04:07

You have been through so much...this is a piece of cake! Make your vacation plans and let your pm do the worrying and monitoring.

Take care,

Grateful Heart

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