tach after respiratory illness

I am a 59 year old female, almost 6 months post-op for a Medtronic Sensia dual chamber PC. I also have severe chronic bronchial asthma. I have been housebound with a severe episode of bronchial asthma (no pneumonia this time) for almost 6 weeks now. The lungs are mostly clear, but I am getting tach bouts of 125 - 140 bpm everytime I get off my chair to do anything. It takes awhile for them to finally go down to normal. I have been on heavy duty steroids and antibiotics for the asthma for 5 weeks, but have been off them for a week now. I have upper belly bloat which is crushing at times. I also have some pain where liver and spleen are located. My asthma doctor says it will just take time to heal, but now I also have this issue of tach also. Has anybody had anything like this and what do you do about it? I feel as though something else is going on beside asthma but my blood tests only show a slight increase in white blood cells which they attribute to all the steroids I have been on. I just can't get on top of this, whatever "this" is, and wonder if I am ever going to feel good again. I had been doing so well with the PC before this came about 6 weeks ago.
MOJO

11 Comments

PS

by IAN MC - 2013-12-03 01:12:10

I should have said that these meds don't actually contain adrenaline as such but the Beta 2 agonists, as they are known, do mimic the affect of adrenaline and therefore can cause tachycardias.

Ian

Asthma Meds

by IAN MC - 2013-12-03 01:12:15

Tracey is right . Commonly used bronchodilators such as salbutamol and terbutaline not only open the airways for asthmatics, they can also affect the heart and cause arrythmias and tachycardias in some people.

I assume, Mojo, that as well as taking steroids and antibiotics you are also on bronchodilators ?

Best of luck

Ian

I'm still not a DR. But...

by donr - 2013-12-03 01:12:29

Mojo: Here are some additional things to think about to help your ANXIETY level:

(Thanks, Ian for reinforcing what I am about to say. You posted it while I was typing.)

1)YOU: I put on 23 pounds of fluid from the steroids, mainly in the upper belly and face, but some leg and ankle bloating also. The antibiotic was 800 mgs. Amoxi-Clav 2 times daily which wreaks havoc on my stomach and intestines also. I have a history of Ulcers and Ulcerative Colitis. I don't do well on any antibiotics.

ME: Yep, that'll really mess you up & can make you feel like crap all over for some time. Here's a link to a site that will confirm that steroids will do to you what they did to you: http://www.mayoclinic.com/health/steroids/HQ01431

2) YOU: Didn't know steroids could affect the adrenal glands.

Me: Yep - see the link I gave you from Mayo Clinic

3) YOU: Every time I get up the heart rate goes up. If I do the dishes, or get the laundry, etc., it stays at 135+ until after I sit down and then it calms down after 3 or 4 minutes of resting. That can't be normal, can it?

ME: No. that is NOT normal. BUT: 135 is not exactly V-Tach - but it uis a higher than normal rate & would seem to you like racing. BUT: Since it is associated w/ a specific action & returns to normal when you stop, there is a correlation between the two. You do need to talk to your cardio about it.

4) YOU: I guess I'm not sure at this point if RR is off or turned down. I don't remember. What would be best in my situation?

ME: Have them confirm what the RR status is. You said in a post that it was turned off. This sounds like it could still be on, but turned down. One simple test you can do that MIGHT tell you if it is affecting you is to stand up & start rustling around till your HR goes up. Then stand stark still for a few moments to see if your HR goes back down. Best sounds like you want it OFF. BUT - that is for your Cardio to decide in conjunction w/ you.

5) YOU: I coughed my guts out for 3 solid weeks, with terrible pain in the upper belly every time I coughed. The doctor had me go in for a chest x-ray and CT scan to make sure I didn't have a blood clot or pneumonia. I did that the first week into this 6 week period. I still have constant pain in upper belly and it is still bloated although I have lost 11 lbs. of fluid in the last week. I am still coughing, but not too much anymore.

ME: Coughing your guts out for 3 weeks will irritate the daylights out of any & everything involved. Even the steroids that prevent irritation cannot stop that completely. Coughing is so violent to the heart location that it is touted as a method to perform self - administered CPR if you think you are having a heart attack. Still coughing - still irritating yourself.

6) YOU: If fluid has collected in heart sac, would that go away on it's own?

ME: Yes, all by its little lonesome, but it will take a while - perhaps weeks, so don't be surprised.

7) YOU: You mentioned belly bloat pressing on diaphragm - could that be causing my hoarseness? I still can barely talk after 5 weeks of being hoarse. I whisper mainly.

ME: NO - the coughing irritated the voice box & upper airways - that's what's causing the hoarseness. This, too will pass if you take enough "Tincture of Time" pills. that's a fancy way of telling you to be patient. AND to stop trying to talk.

8) YOU: I have broken down a couple of times, the last being 3 days ago. I feel like I'm never going to feel/get better again.

ME: Yep - that's the way you will feel. EVEN if all is going well otherwise - & it's not. You feel like crap & swear you will never get well again. Asthma after an acute outbreak will leave you this way. Be patient & look for small victories

9) YOU: Loved your quote. How true it is.

ME: Learned that quote over 50 yrs ago. Never saw the association w/ heart /asthma problems till recently. But old Bonapart was correct.

Lemme warn you: Asthma has a terrible psychological aspect to it, even moreso than any other malady. Some psycho issue can trigger an asthma attack or make it worse in the blink of an eye. You have just survived a severe asthma assault - you will be sensitized to it & they can recur on you very easily.

Go up to the SEARCH feature , top right corner of this page. Search for a post I made about a week ago "Facing Adversity" Read of my adventures deer hunting in MO when temps were bitter. I have asthma, also & could sense when I breathing problems that were started by the cold, but made infinitely worse by my psychological state


YOU: I will try to get ahold of my cardio but think he is out of town this week. I do have an app't to see him next week, but wonder if I can wait that long. I just hate to try to explain everything to the doctor on call when he doesn't know me like my own cardio.

ME: Good idea. BUT - see your regular guy. You wil feel better psychologically than if you talk to a stranger. You need to have your head treated in this case. Anything to make you FEEL better as far as anxiety is concerned.

Don











thanks again

by Mojo - 2013-12-03 02:12:45

This is Mojo again (Marilyn).
I use Symbicort - 2 puffs in AM, 2 in PM. I know that they tend to elevate the heart rate, and I have been using them for almost 5 years now. I have avoided using my nebulizer meds this past week, which also elevate the HR. I didn't get this fast heart rate until 3 days ago, and therefore my concern now. (Sorry I didn't write that down before.) But today I am getting irregular beats. I called my cardio office and found out my doctor didn't go away as planned and will see me this afternoon. Thank the good Lord for that. I'll let you know what he says.
I just want to thank you all for your concern and help. Don, as my husband says, "you're a man among men". I will be looking at the sites you mentioned, and I truly thank you for addressing all my concerns so quickly.
Marilyn

You did it all

by donr - 2013-12-03 03:12:22

By asking questions & dogging your cardio.

Sounds like he will take care of you.

Don

Yeah, same for me

by Theknotguy - 2013-12-03 03:12:35

Had my PM implanted under a major trauma condition. My body was ringing like a bell and nothing seemed to work. I had to wait for the body to calm down before I started seeing results. Thought it would NEVER happen.

Getting rid of the fluid will help. Trying to look forward and not focusing on the present will help. (I know, hard to do when every little twitch and pain sets you off.

You may want to ask your cardio doctor if you can take something like Metropolo - it will slow down the heart and maybe get rid of the palpitations. However, your heart may be going to slow as is so, you may have to tough it out. (I did.)

Hang in there. It gets better.

Theknotguy

Mojo's doctor visit

by Mojo - 2013-12-03 07:12:24

Just got back from my cardio. He spent over an hour with me even though he had 8 patients in the waiting room. I felt bad that I took up so much of his time, but he said that that was what he was there for. Great doctor.
I have developed another a-fib. I didn't know that was possible on a pacemaker, but I seem to always be the exception. I have been in constant a-fib for a week but not a high a-fib, only 120 - 158. My RR is on; he tried turning that off months ago with bad results, so he didn't want to do that again. He reprogrammed the PM again and hopes I will naturally come out of the a-fib on my own within the next few days. A PM can't be programmed to get rid of a-fib tachycardia. If I still have the tach when I see him on the 10th, he will have to shock me and then reprogram me to where I've been good for so long. But, he said the tachycardia will come back again at some point. In the meantime he doesn't want me to do much between now and the 10th hoping it will come down naturally on it's own. But he also doesn't want it to continue very long because it will weaken the heart. He showed me everything they did today, explained it all, even though it's a lot to take in and truly understand everything. I'm so thankful to have such a caring doctor. And very thankful to all of you.
Marilyn (Mojo)

Mojo: Congrats!

by donr - 2013-12-03 10:12:15

You did it - REALLY. All we did was prop you up & shove you out the door! That is a good Cardio - he treated your head more than anything else. You sound nice & positive. Kinda nice to have one who does that & leaves you w/ a comfortable feeling.

Hey - & he's in the great MID West!!!!! Bostonstrong - you were correct!

Did he say anything significant about the asthma, coughing & all the meds?

Now then,, keep us all posted on PROGRESS. You will see better days ahead.

Don

I'm no Dr, but...

by donr - 2013-12-03 11:12:03

...Let me give you a few things to think of. I have no idea if they are really the reasons for your situation, but at least it's a start early in the AM.

1) Heavy duty antibiotics & steroids: Boy, they can mess you up something fierce. Did the steroids make you put on more than a few lbs? Our daughter was on them for 6 weeks & gained so much weight that she was literally un-recognizable when she picked us up at an airport. How about the antibiotics? Any side effects? What was the antibiotic? I believe that some of them can cause arrhythmias, also.

2) Steroids can mess up your adrenal glands. It also takes a while to get rid of the after-effects of steroids, so that may be causing the problems.

3) You describe it as happening every time you get out of your chair. Hmmmmm - there's a correlation of some sort there. Stars out w/ a rush of adrenalin to make your heart go faster. That would be a transitory thing if you were NOT facing an armed robber or a angry tiger.

4) Your RR coud be acting up. BUT you report that they turned the RR off. Is it REALLY off, or perhaps just turned down?

5) Did your asthma cause a lot of coughing? That could conceivably irritate all sorts of tissue around the chest area, including the heart muscle - including the area where the nodes are.

6) Did the steroids make you retain fluid? Again, you could have some that collected in the heart's sac, causing all sorts of discomfort.

7) Upper belly bloat - that could be putting pressure on the diaphragm & heart, causing discomfort & perhaps weird things electrical.

8) All these things can affect your mental state & cause you anxiety. Anxiety can wreak havoc w/ things electro-cardio. Must be having some effect on your mental state - you wrote this note asking about it.

Why not contact your cardio & ask him about these issues that I have raised - it might ease your mind considerably.

9) In this business, "The mental is to the physical as three is to one." (Napoleon) Especially when talking asthma combined w/ cardiac problems.

Don

thank you, Don

by Mojo - 2013-12-03 12:12:18

Don, I really appreciate you taking the time to point out all those questions.
1) I put on 23 pounds of fluid from the steroids, mainly in the upper belly and face, but some leg and ankle bloating also. The antibiotic was 800 mgs. Amoxi-Clav 2 times daily which wreaks havoc on my stomach and intestines also. I have a history of Ulcers and Ulcerative Colitis. I don't do well on any antibiotics.
2) Didn't know steroids could affect the adrenal glands.
3) Every time I get up the heart rate goes up. If I do the dishes, or get the laundry, etc., it stays at 135+ until after I sit down and then it calms down after 3 or 4 minutes of resting. That can't be normal, can it?
4) I guess I'm not sure at this point if RR is off or turned down. I don't remember. What would be best in my situation?
5) I coughed my guts out for 3 solid weeks, with terrible pain in the upper belly every time I coughed. The doctor had me go in for a chest x-ray and CT scan to make sure I didn't have a blood clot or pneumonia. I did that the first week into this 6 week period. I still have constant pain in upper belly and it is still bloated although I have lost 11 lbs. of fluid in the last week. I am still coughing, but not too much anymore.
6) If fluid has collected in heart sac, would that go away on it's own?
7) You mentioned belly bloat pressing on diaphragm - could that be causing my hoarseness? I still can barely talk after 5 weeks of being hoarse. I whisper mainly.
8) I have broken down a couple of times, the last being 3 days ago. I feel like I'm never going to feel/get better again.
9) Loved your quote. How true it is.
I will try to get ahold of my cardio but think he is out of town this week. I do have an app't to see him next week, but wonder if I can wait that long. I just hate to try to explain everything to the doctor on call when he doesn't know me like my own cardio.



adrenalin

by Tracey_E - 2013-12-03 12:12:44

Isn't adrenalin, which makes your heart beat faster, in a lot of asthma meds?

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I'm 35 and got my pacemaker a little over a year ago. It definitely is not a burden to me. In fact, I have more energy (which my husband enjoys), can do more things with my kids and have weight because of having the energy.