Maybe IST and Constant awareness of heartbeating!

[glassheart46]

I am now 2 months post ablation for avnrt(slow pathway), atrial tachycardia, and extrsystolies.  All three burns done in the crista termanalis region.  I still experience short periods of gradual speedups,(usually gets up to 100bpm) some pvc's and pac's. My resting hr on toprol is 74bpm. It seems as though the episodes are less severe but a little more frequent. My EP has stated that I may have IST temporary or permanent.  The jury is still out. I am constantly aware of my heart rhythm and that sometimes makes me anxious and I wonder if I am creating the speedups due to adrenaline release.  Prior to ablation I was rarely aware of heart beat. Questions today are: 1)What can I do to become less aware of the heartbeat? Right now I am on Toprol XL, 50mg per day in divided doses. 2.  Would it be a good plan to try a different beta blocker or do you feel I am getting the best out of the Toprol given my symptoms above? 3. Could I be adding to the problem because of adrenaline?  When these eipisodes occure I do deep breathing which helps sometimes to shorten the episodes.  I am hopeful that this will resolve over time but if not I want to be as informed as possible as to ways to help minimize the episodes.  If this were one of your patients with the above, what beta blocker would you recommend?  What other recommendations would you give? I might add that prior to this I was not an overly anxious person.  I believe that these types of problems, even thou not life threatning, can cause greater damage to one mentally then physically and I truly want to avoid that. Thanks!

[CCF-M.D.-RCJ]

glassheart46,

Happy Holidays.

Firstly, the presence of a resting heartrate in the 70s virtually excludes IST as a possibility.

Q1:"What can I do to become less aware of the heartbeat?"

Some people have good luck with "alternative" strategies, such as yoga, biofeedback, or imaging techniques.

Q2:"Would it be a good plan to try a different beta blocker or do you feel I am getting the best out of the Toprol given my symptoms above?"

A high dose of metoprolol could be tried.

Q3:"Could I be adding to the problem because of adrenaline?"

Do you mean to say "Could anxiety be contributing?"  If that's what you mean, then Yes, absolutely.

Q4:"what beta blocker would you recommend?"

I usually start with metoprolol (Toprol), and then try nadolol if the toprol isn't agreeing with them.

Good luck.

[nurse12hr]

First, I sympathize with you.  You seem to be having a very rough time with these symptoms after having a procedure done that you had hopes would end them.

But I have to say, you are probably not helping the situation by continually focusing on what your heart is doing.  Stop taking your pulse.  Stop pausing what you are doing when you feel the tell tale "flip flops" in your chest.  Practice ignoring them.  Briefly tell yourself you are fine and go about your business.  If you don't exercise, start if it is ok with your doctor.  Push yourself, push yourself hard.  

You will not die from these ectopic beats, nor is some very mild intermittent tachycardia going to kill you or harm you.  You have to tell yourself this every day until it becomes part of your belief system.  You have done all you can thus far, but spending your life taking your pulse and worrying about heart rates and skipped or extra beats is probably contributing to the fact that you can't ignore them.

I have pvc's, pac's, and frequent runs of mild to moderate tachycardia all the time.  I KNOW they won't kill me, and because I don't focus on them, they don't bother me at all.  I exercise on an elliptical trainer for about an hour a day, and also do weight training.  I have been having some chest pain, but since having it evaluated and diagnosed as atypical angina that will ALSO not kill me, I take reasonable care and just go about my life.  Don't have time to worry about the "what ifs".  

I know it sounds harsh, but I truly believe if you cease any and all activities involving worry about your heart, you will eventually desensitise yourself to feeling them.  If I concentrate hard enough, I can feel plenty of pvc's.  So why on earth would I WANT to concentrate on feeling them?  

Again, I don't want to diminish what you are feeling, but it is obvious you are spending a lot of time focusing on your heart.  Try to find SOMETHING else that you can devote lots of time and energy on, and consciously STOP YOURSELF from thinking and worrying about your heart.  It won't help, and is making your life miserable.  

Wishing you a healthy, happy New Year.

[mbimom]

Just a comment. I had an ablation done in2001 for SVT. I also had ALOT of palpitations afterwards. I used to keep one of those heart rate monitors on almost all the time to watch my heartrate. The doc put me on toprol and after a while I started to feel better. I also learned what triggered the palps for me and stopped drinking or eating these things. I now am off the toprol and hardly ever get them. I think the further away from the ablation you get the better you feel.

[raildown]

glassheart, christie's message has a Lot of merit..a tough love kinda thing;

within the world of 'panic syndrome', there is a term 'HFA - Heart Focused Attetion' used to describe how some folks Focus maladaptively on these symptoms to the point of these maladaptive behavioral practices becoming a much bigger problem than the underlying symptoms;

your nickname here, even while being evocative, is indicative of your global view;

a practice called 'mindfullness' training (see the books of Jon Kabat-Zinn whose programs have had a lot of success with chronic pain syndromes starting with his clinic at the Univ. of Mass/Worcester's pain clinic)...the underlying concept comes from Buddhism and involves viewing (paying 'attention') your perceptions of your body's signs 'in the moment' without 'judging' them...anxiety comes from projections into the future (depresssion in views of the past)...just be 'here now' and kinda get up close and personal with pain/symptoms/sensation without judging and projecting...a process a bit like 'normalization'...it's a little slippery to quickly absorb but when practiced regularly (and after a time, often in short bits during the daily routine) it has proven effective in chronic pain and anxiety syndromes not withstanding the underlying pathology;

be well;
//

[nurse12hr]

Absolutely correct.

The more attention you give something, they more it will grow.

  I don't consciously use the technique you describe, but it is just something I have always done intuitively.  As a nurse, I see people absolutely crippled by fear of disease or over attention to minor symptoms.  To the point where they just stop enjoying life altogether.  

Life is too short.  Find something to do that you love, and do it.  Don't let obsessive thoughts ruin your life.

(along that line, fear of illness often has an obsessive component and can be helped by a trial of medications used in obsessive compulsive disorders).

[glassheart46]

Thank you for your inspiring comments.  I just wanted both of you to know that 2 weeks ago I started a fifteen week course on anxiety and depression.  I am very aware that I may be the culprit that is causing my own fear, anxiety, symptoms, etc.  I have also started to exercise.  For the past two weeks I had been working on exactly what you guys mention.  As for my name "Glassheart," that is the name of my stained glass business I started 12 years ago and has nothing to do with how I feel about my heart.  I thank you both again as I am in total agreement and I will print up both of your comments and keep it near me as I work through this anxiety/depress/fear thing.  I am also scheduled to see a fear/anxiety/depression counselor next week.

[jobob52 ford]

You may remember me, a WPW patient, 2 failed ablations(2001 and 2002, the Docs knew they were failed and started me on meds again right away).I went for another ablation in Sept. 2003, at Cleveland Clinic, the Docs felt this one was a success. For the first couple of months I felt a few flutters and had a few 1-3 minute runs of a-fib but they were diminishing. I had responded to a post of yours or one from LynnSB and stated how I needed to just stop thinking about it, in fact the times I felt them most were when I was at this site. The next day at work I frequently wondered what sort of responses I'd get. I don't remember what they were, nothing too controversial, at any rate, that night at midnight I went into a-fib that lasted till 9:00am. I didn't stop coming to this forum but I did emotionally distance myself. In the mean time I had signed up at Church for a 6 week class on forgiveness. The class seemed to work as a diversion of my focus, as was talked about earlier in this thread, now I just don't have any symptoms and for awhile if I felt a flutter, by the time I put my finger on to check pulse, the flutter had ended. I don't bother anymore. Now I'm almost 4 mos. post ablation and this aint bad.
I want you to know that I sympathize with you and wish the you best. Don't give up!
( I'll also add that I'm just a little curious to see what happens with the anxiety of making this post.)
Isn't Life a Hoot?
Bob

[raildown]

roger on the nickname, I love glass art and I collect old stained glass windows as well as blown glass art;

f.w.i.w. I get/notice more of the scapular pai, left arm apins when visiting these forums bu curiously not when reading dead-tree information about CAD etc...something about the ergonaumics (sp?0 of the posture, sitting position, screen cotrast etc...hmmmm...;

" 90 % of thinking is half-mental " (approximately)(Yogi Berra)...;

the Power of the mind is formidable (ongoing studies of -other-Buddhist-Far Eastern yogis ;-) by MIT scientists and those at Univ of Wisconsin have documented truly amazing abilities of mind/body power) - ...some of this CAD is unknowable currently and likely to some degree always, certainty is ellusive, and life has a lot of mystery....one can learn/do so only so much, and then we must Live for the time given to us...;

peace;

out;

//

[glassheart46]

Merry Christmas to you as well!  Yes, I found that splitting the Toprol seemed to be better.  My EP doc agreed and gave me permission to take the split dose as he to felt it would be better for the palps.  Hope you are doing well too Hank.

[Momto3]

Hi Fred, I have had 2 pvc ablations and so far, so good. I'm always kind of surprised when I read about people who have pain associted with pvcs. Even though I had thousands/day, I never really had any direct pain from the pvcs. I was just curious, is it like angina, or some other type of pain? Also, you seem convinced that pvcs are not behind...do you have a personal experience that leads you to that statement. Don't know if you know my story, but the short of it is that frequent pvcs has led to cardiomyopathy. I am told this is quite rare, and I wondered if you ran into something similar. Are you a candidate for an ablation? That really seems to have settled them down...Keeping my fingers crossed.

Sorry you are still plagued by these darn things.

connie

[nurse12hr]

Fred,

Don't you think, with the probably hundreds of thousands of people who have pvc's, that they would be dropping like flies, and developing terrible cardiac problems?  Don't you think the medical community would be scrambling like crazy to find effective treatments for this common phenomena if it were extremely dangerous?

Yes, rarely, PVC's can cause problems.  So can a lot of things.  (For example, you COULD develop necrotizing faciitis from a paper cut and die, but I would be hard pressed to go around saying "paper cuts can be fatal". Strep throat can kill you under the right circumstances.  Women die in childbirth.  These examples are probably overly simplistic, but you get the drift).  So yes, occasionally someone with PVC's could develop a problem.  Bad things can happen for little or no reason at all.

I am sorry that you have been one of the unlucky ones.  But far more often, people develop a fear of cardiac disease from having PVC's that is often FAR more crippling to their everyday lives, and leads to them going from doctor to doctor, taking a dangerous cocktail of medications that could ALSO cause problems.  Medications used to treat these are not benign at all.  

I'm afraid I will have to go about my life willy nilly, ignoring my PVC's until something worse happens.  I have gotten to almost 50 with only some pesky problems.  These problems I have overcome are breast cancer and degenerative disc disease.  I keep an upbeat attitude, do what I love, work hard, and play nice.  I ignore any and all things that can interfere with the enjoyment of my life--the only one I will likely have.  

Positive begets positive--concentrating on negatives can't help anyone, and I chose not to live that way.  Sorry if that is too "new age"--we all have to do what helps us, and concentrating on living and enjoying my life has seemed to help me get through the rough patches.  

I do hope you find peace and good health soon.  You have my sincerest good wishes.

[mightymuppet]

Well said!

[Kimma]

the more i read about your problems the more i realize we are the exact same. you said you dont get very many pvc's well until about 4 monthes after the ablation i didnt have even have one pvc. i also get short runs of tachycardia, usually right when i stand up, i had this from the day i went home after the ablation. i told the doctor about it and she said its nothing to worry about so i went on with my life. then the pvc's started thats when i became aware of my heart beat 24/7. even on the atenolol at 75bpm i could still feel every beat. it is the most annoying thing ever and it has made me obsessed with my heart. i still think something is wrong, i dont think im supposed to feel this way. i had to stop taking the atenolol because it made my blood pressure drop and even before the atenolol it was 88/56. my blood pressure was never that low before the ablation. wouldnt it be great if everyone was right and if we just stopped thinking about our hearts it would all go away? its not that easy to forget about something you can feel pounding in your chest all day. i know how i felt before the ablation and i know how i feel now and something just isnt right.

[Momto3]

Hi Christie!!  WOW! That packed a powerful punch, and I loved it!
You are so so so right about a positive attitude.  Thanks for contributing so beautifully!

Fred,

I meant to say "benign" not behind......sorry!  Hope you are feeling better.

[glassheart46]

Yes, it is so annoying hearing my heart beat 24/7.  Prior to the ablation I would have to feel my pulse to see what my heart was doing, which I didn't do too often and never did until I started having all of these problems.  What is your resting hr now while on medicine?  Do you still get bursts of tachycardia?  My resting hr is around 74 or so.  After eating it goes up into the high 80's and then gradually back down in the 70's in about an hour or so.  I get small bursts of tachycardia every week or so, sometimes more but usually goes away within a few minutes.  I have only had two episodes that lasted longer and were much faster then the small ones.  It has been two months for me now since the ablation.  It has me very depressed but I am working on that.  I am still hopeful that I am just a slow healer and it is from nerve irritation.  The EP doc said I needed to give it 6 months and in some cases up to a year or so and this could diminish.  The Toprol I take does not prevent me from getting the tachcardia but it does keep it down some.  If you want to email me my address is:
  ***@****
It would be nice to hear from you.  It is hard for some people to understand that these things take time to overcome.  This heart thing is pretty new to me but I am trying hard to get through it.  I would like to add here that this is not my first tough life experience.  I have been through spinal surgery, and many other surgeries.  I lost the use of my leg due to spinal injury when I was 30 and was told I might ever walk again.  It took over a year and I was walking.  That ordeal did not hold a candle to what I am feeling about this ordeal.  I do not know what it is about this but I was fine prior to the ablation but the minute I awoke from the procedure I was aware of a rather rapid heartrate and for the first time since the birth of my third child I found myself deep in a depression.  I could not believe what I was feeling.  I honestly believe that the trauma of the ablation threw me into the depression.  I had been through a lot the last 8 months before the ablation.  I had to have emergency gallbladder surgery, and have severe cervical disc problems and a torn rotator cuff which I have to have suregery for but can't until the heart problem clears up. In the meantime, I deal with that pain as well.  Prior to the ablation I could at least drink coffe which helped the pain a lot.  I cannot handle pain meds so now have to deal with all of that pain as well as the heart problem. It has not been a great 8 months for me but I am trying despertly to keep going.  I think when to many things start piling up without resolution a person's emotional state becomes impaired.  I hope all goes well for you too as I know you are very young to be having all of these problems.  I have lived a great life, have three great daughters and 6 wonderful grandchildren.  You take care Kimma and feel free to email me anytime.

[sheryl1945]

Christie, you are fantastic!  Your sound and sensible advice is priceless.  You are so thoughtful to write in and go into detail and I want you to know I appreciate it VERY much!  You and hankstar are my heroes :)  And Christie, you are absolutely right about everything.  The more you focus on something, the bigger it becomes.  I know this from experience!  Since I've ceased concentrating on my heart, I'm much less aware of it's beating and I'm so much more comfortable.  Happy holidays to you and may God bless you.

[nurse12hr]

You are very welcome.  I understand pain very well, but acknowledge it and go on.

[glassheart46]

I am so sorry to read of all of what is going on.  It has to be truly devasting.  Pvc's are darn scarry as it is not to mention in the light of a recent heart attack.  Have you though about going to the Cleveland Heart Center or had you already done that.  I had not read you first posts so forgive my ignorance.  I intend to go to Cleveland Heart Center for a second opinion but am going to do it over the internet.  Cost is around $600.  I wish you well and take care.

[Momto3]

Fred,
Thank you so much for answering my questions. I had NO idea that the pvc pain could be so brutal. As I said, I had tons of them, but never had any pain, so I could only figure it was like a pressure-type pain. WOW! No wonder you are so miserable with them. I imagine that you have already tried medications, but do they help in your case? Also, since your pvcs followed an MI, I am sure there is much more to consider. Are you anywhere near Cleveland? I have a wonderful EP in the Cleveland area and of course, there is the CCF too.

I have not found too many research papers that back up the notion that pvcs are harmful, but there are a few out there. My doctor may actually write up my case, depends on some additional testings, etc. When she was researching cardiomyopathy as a result of pvcs, she could only find one report, but that was enough to send her on a deep expedition.  I am truly grateful for a persistent EP!

Only the best as you continue to pursue good medical care in your quest to feel better.

[Momto3]

An added note based on my earlier comment to Fred:  Although I believe that in rare cases,pvcs CAN lead to medical problems, in the setting of a structually normal heart, they are not generally of concern. That is not to minimize the effect they have on quality of life. I still equate it best to those who suffer from migraine headaches. Although there are a number of effective migraine medications to treat the symptoms, there is almost never an underlying medical cause. It is hard to imagine that a person can be so incapcitated with headaches that something isn't terribly wrong. But, like pvcs, there is almost never an underlying medical problem. Again, none of this is being said to minimize the severity of the pain and debilitation pvcs (or migraines, for that matter) can cause. However, once your doctor has confirmed that there is no danger, it is best to focus on reducing or eliminating the symptoms.  

I believe that each patient is different and that in some cases pvcs are physically or psychologically debilitating while in others they are merely a nuisance. For example, with over 20000 per day, I was not as symptomcatic as others who have 500 per day.  So, to those of you with pvcs, do not panic. Consult with a reputable doctor; have the tests; trust your doctor; and live your life the best way you can.

[Momto3]

Hi Hank!

Same to you...HAPPY NEW YEAR!! You asked how many of the 20000 pvcs I would actually feel. I'm not really sure. I could feel LOTS of them, and the runs definately caught my attention, but I think because I had SO many it kinda felt "normal" to me. I was probably just so used to my own heartbeat.  ODD, huh?  hahaha!!
What's really strange is since the 2nd ablation, when I get an isolated pvcs, I'm like.."HEY, what the heck was THAT?"

Since the 2nd ablation, I have only had one bad day, and that was Christmas Eve. Had pvcs for aout 6 hours, and they were driving me nuts!  I'm hoping that wasn't a prelude to anything on the horizon.

Hope you are doing well. I know first-hand about the effects of "holiday heart". This year, for the first time in I don't even know how many years, my heart was calm throughout most of the festivities (well, except for Christmas Eve). It was really nice. I won't know till February if the procedures were effective in stopping/reversing the CM, but I'm keeping my fingers crossed. In the meantime, it's nice to be in sync (a big change for me...lol).

Again Happy New Year to you and yours!!
connie

[regan]

I am also very aware of my heart beat. It races sometimes but not to often. I have PVC's and PAC's quit often probably 1500 a day. Some days I have less. When does someone need the procedure called ablation and what exactly is it? Also what is cardiomyopthy and can that be something people with pvc's develop?

[Momto3]

In answer to your question about when a person needs an ablation, I think it varies greatly from patient to patient. For me, I have had pvcs for as far back as I can remember (over 20 years), and they were always considered benign. I was having over 20000 on 24 hour holters and there was still no medical concern. Basically, it was up to me as to whether I wanted to "treat" the symptoms. I took a beta blocker (Inderal) on/off for probably 10-12 years. In 1998, I went off the medication and decided to just deal with the symptoms. I think I was pretty much used to the pvcs and so I am not sure I ever really knew what "normal" felt like...weird! Anyway, when I had my annual echo (to monitor MVP and mitral reguritation) the tests revealed cardiomyopathy and it was determined that the pvcs were likley the culprit. At that point, I had a choice of taking antiarrythmics (YUK) for life or attempting one or more ablations. Ablations are done in an electrophysiology lab where doctors and technicians map the electrical system of the heart. When they find the irritable spot (foci) as in my case, they zap it with radiofrequency. The first EP study resulted in an ablation to my heart's right side; the 2nd ablation resulted in a zap to the left...I will have another echo done in February to see if reducing the number of pvcs has reversed or improved the cardiomyopathy. Most people with pvcs lead a perfectly normal life. Once you have had the standard tests and your doctor has  reassured you that you are fine, you should try and do your best to forget about the palps.

Incidentally, for the vast majority of people pvcs are completely harmless.  Good Luck to you!

[regan]

Thanks for responding to my questions ! I don't want to worry about these palps but they are so hard to ignore. What is cardiomyopthy and did you have any addition symptoms w/ it? Also do you or have you ever experienced anxiety associated with the palps? If you don't mind me asking how old are you? I too have three children. A daughter 10yrs old a daughter 8 yrs. old and a son 2 1/2yrs. old. By the way my name is april. My son is Regan.

[Momto3]

Hi April!  I am 46 (YIKES!!) and my kids are nearly all grown. Anxiety is a regular part of my life...as my husband and kids will definitely attest to...hahaha!!! As I recall, when I was initially diagnosed with the palps, I was not bothered by them. My docotr picked up on them before I really knew I had them. However, as I got older, I noticed them much more often. Right around the time I turned 40...SLAM!! Many people on this board will tell you that their palps wax and wane, and that some "storms" (or bad spells of them) are worse than others. I have found that to be so true. Over the last several years, I have had many thousands recorded on every monitor. They really didn't worry me, probably because I was so used to them. Now, when I get an isolated pvc, I NOTICE! That's since the ablations.

Cardiomyopthy means that the heart's ability to pump is impaired.  Funny thing is, when I went to the doctor with extreme shortness of breath, it was determined that my heart was not the cause. I had a couple of echos and a TEE (ultrasound of the heart from inside) and they came out fine. It wasn't until about 2 years later that the cardiomyopathy showed up and I was not nearly as short of breath--not even close! It is believed that the frequency of my pvcs was the cause of the impairment.

Have you had the standard tests to rule out anything else going on? You are right, the palps can be difficult to ignore, but you will find that that is the best "medicine". You'll probably notice that when you are busy, you are not nearly as aware of them. I once had the doctor tell me to just keep running in circles because my stress test showed when my heartrate was up, the pvcs would disappear. If he only knew how much I ran around (kids were younger and we were always on the go!)

Once you have had the palpitations checked out, you should be able to relax. Try not to focus on them, cuz as you are finding out, they can create a vicious circle of anxiety.

On my last visit to the EP (December), she said she thought that was the first time (in 5 1/2 years) that she ever listened to my heart in rhythm...I ALWAYS had palps.

By the way, I LOVE your son's name!!

Connie

[regan]

It feels really good to talk to someone who knows how I am feeling. I have had a few tests Halter, stress, echo and some blood tests. They all came back ok. I just have so much built up anger that I feel it's making the palps worse. The anger comes from letting this take over me for the past year. Did you feel this palps at 29?

[Momto3]

Hi April,

OH YEAH, I felt them at 29!! You bet! I began feeling them in my twenties, and they really peaked in my thirties. Although I have had them for over 20 years, there have been times that they were not so bad, and times that they were NUTS! You are definitely not alone. Did your doctor suggest a beta blocker?  Sometimes they help to prevent or reduce the number of pvcs? I took them for many years, and finally opted to "live with it". As I recall, it was in my late 30's to right around 40 that I was hit the hardest.  There are many of us who believe that hormones play a role in our particular situations. Others have found other "triggers" (caffeine, alcohol, stress, etc). I think as long as you have had the echo, EKG, and holter you are probably just fine. The only thing I might suggest is an event monitor. You wear it for 30 days (sometimes less, sometimes more) and you hit the button when you FEEL a palp, etc. This way, the doctor can see what you actually feel. The holter monitors are nice, but because they are for a specific 24 hour period, sometimes they miss what you are feeling.  I like the idea of a month long monitor because it catches you on your best days and your worst days. Just a thought if you are still concerned. I'm glad to have the opportunity to help someone else. I definitely KNOW what you are going through. Maybe ice cream will help. I know it helps me, at least for a little while : )  connie

[regan]

Thanks again. I have an appointment to see my doc Feb. 10th so I will as about that monitor. -April

[dhope]

Hi

I been reading on and off about thinking and feeling heartbeats, and I suffer with this sooooooooooooooooooooooooooooo bad, I had this for about 15 years.  The skips, misses and palpations just come, and I know when your upset or even happy pop one comes up.  I am trying things now vitamins, and such but there is no magic cure, I been on atenolol for awhile and hate it I cut down the dose.  Would love to go the natural root, now that I am in my forties it got worse who know premenopause I don't know but I just feel like crying and I fight to go on this thinking it makes me well you know.  I am going to start counseling soon, and I haven't tried yoga yet but I am scared that it’s been like this for so long can I get better god I hope so.  I am sorry so many others suffer with palps.  I am vegetarian and have low blood pressure and I think also when your digestive system is out of whack the heart is affected by it.  

This is a very informative site

[Tom Hunter]

I don't think my situation is as serious as some of those described.  But, I thought I'd pass along two things that may have helped me.

In short, I had flutters 10-30 times a day.  These recently dropped off to nearly zero, but I do sometimes still get them. I've done the Holter moniter, numerous ECGs/EKGs, visits to cardiologists, and even an attempted ablation procedure (the could not replicate racing heartbeats I used to get, so they did not ablate anything).

The following seems to have helped me.

One, Magnesium supplements.

Two, chocolate. No kidding.  Ever since I started eating chocolate or drinking hot chocolate each day, my palps all but disppeared.

I think my problem may be "holiday heart", as I do like to have 1-3 glasses of white wine per night.  Planning to quit entirely starting tomorrow to see if that is the cause of the problems.