My dad is not feeling well, can you help?

[thepurselady]

Dear Doctor,

Im sending this in for my father.  He is going to be 74 Feb 14th.

Here are my concerns.

My Dad see's his Doctor regularly.  He is taking these medications:

Proscar 5mg   Once daily
Selenium  200mcg   Once daily
Niacin    250 mg       Twice Daily
Glucotrol  XL  Tabs  5mg  Once Daily
Diltiazem XT (Cartia XT) caps   240mg   Once Daily
Lisinopril/HCTZ Tabs     Once Daily
Multivitamin/Multimineral Supplement    Once Daily
One Asprin Daily - one regular dose pill
      
He is  milder diabetic under control with oral meds.  He has been a healthy dieter for the past 15 years, watching his fat, does not eat
much sugar if at all. Focuses on the Atkins plan for his sugar, avoids Carbs,  Works out daily on the treadmill.  He has been experiencing some episodes of what he calls
a "shaky" feeling while he is lying in bed in the morning.  Its a very upsetting feeling, when i asked him, try to explain, he said everything feels jittery
and he feels just not good.  He cant lay in bed or he feels worse -As soon as he get up and gets out of bed for a minute or two, this feeling passes.  He is not a complainer
so i know if he is telling me this, it must really be concerning to him.  He also on occasion (but not daily-maybe4x's permonth) gets a pallipitation that will last for many hours and scares him.
He has a mild perscription for Xanax .25mg lowest dose and will only take it when he feels this palliptiation episode come on.  when taken asap, he can avoid
the several hours of palipatations and they will pass.

Upon awakening with the Jittery feeling (which he describes as the same jitters of drinking several potent cups of coffee) he checks his sugar, which
is always in a lower reading.  So we feel this jitteryness is not due to diabetes?

His Dr does not seem concerned.  However I am and was hoping you could shed some light on what you as a heart specialist may feel could be going
on with my Dad.

Some family history:  His father died in his late 60's of a massive heart attack.  His mother died of a stroke, his older brother died of a massive
heart attack.

My Dad will not persue any invasive procedures to check for blockages, he said his Dr listens to his heart, his artery in his neck, his lungs and says
everything sounds good.  Im concerned that the Dr would not order more testing?

If any of this sounds like a precurser to something serious, could you please give me some advice? Im stuck between a rock and a hard place
because he is very headstrong on what he wants to do with himself and Doctors.  By the way he is a non smoker, non drinker and he never drinks cofee etc.  A model man in his
70's for health.

Thanks in advance for your help!

GT

[CCF-M.D.-RCJ]

GT,

Thanks for the post.

The simplest explanation is often the correct one.  And for your father, that would be that he is jittery from a low blood sugar.  This symptom is very common in diabetics, and often comes on as people age -- either because their diabetes medicine is increased, they begin to eat less, they lose weight without lowering their medicine, a new interfering medicine is started, or their kidney function worsens.

The simplest thing to start with would be for your father to set his alarm for 3-5 am, and check his blood sugar.  If he finds a lower blood sugar then that at other times of the day, then the low blood sugar may be the culprit.

Good luck.

[RubyKat]

i have had irregular heart beatm pounding heart  and sometimes an accelerated heart beat for over 16 years. For a while it struck worse premenstrually, or during pregnancy and nursing, then phased out as the month or years passed between children. About eight years ago I started visiting heart specialists and took every heart test they had. I wore halter monitors and other receptive mechanisms to chart my heart beats. They all they could do for me was to perscribe Xanax and Propanynol. One even suggested surgery to implant a a pace maker- imagine, at only 38 years old! ( I am 47 now)  I never took the medicationsexcept in an emergency if I could'nt get through an episode. They told me many people had "arrythmias" and I must just be over sensitive to them, and notice them more than other people. I didn't buy that explanation. The also told me to see a psychologist for my stress. I was at times incapacitated from these episodes of irregular, pounding heartbeats and couldn't speak sometimes. I called the ambulance once and drove myself to the emergency three times. I also went for 15 weekely magnesium injections, to no avail. I lived on KavaKava and other herbal and homeopathic remedies for months at a time.
  Only one traditional doctor I met had started to suspect a slightly underactive thyroid, yeast, and mercury in my blood.  But he left the profession before we could get a handle on anything much.
   One afternoon I met a doctor at the Whole Health Expo and I made an appointment to visit his office.  He asked me if I wanted to do this the fast way or the longer way. I said the short way-- i had suffered enough. He invited me to not eat any solid food for 30 days, but instead exist on three 12 oz "green drinks" per day (made up of grasses and algaes and acidopholus and about 50 other substanses) and 8 8oz glasses of fresh carrot juice inbetween.  I also started taking some other supplements like oregano, a potent antioxidant, and a few other herbal and nutritional additions including flax oil and some instestinal cleansers.  After a short six days my heart palpitations went away, never to return with the vengeance that they had plagued me for all those years. By the end of the 30 days I had so much energy and felt better than I had in decades.  I still get a remnant pound or skip every now and then, but I can usually narrow it down to over eating, undereating, extreme anxiety, alcohol, ovulation, or high carb intake.  I used to have them at any time for no apparent reason at all.
   I have a feeling the depletion of all my energy and nutrition caused an imbalance in hormones and many other systems in my body. I had had three babies and one miscarriage in the past 21 years, had gone thru a stressful breakup after my third pregnacy, been a single mother for over 19 years, had a history of excessive party life in my sorrid past, had exercised like a crazy person most of the times, and was always "dieting".  My reserves were on empty.  I believe these repeated doses of daily mega-nutrition helped my body get back on track.  I still drink both fresh juice and green drinks at least once a day, skipping only occasionally. Of course one has to avoid the culprits of caffeine, tobacco, refined carbs, processed and preserved foods, etc to get the most from anything.  But the wonderful formula of green drinks was what I think helped me tremendously. Any questions please write. check out drcurran.com

[thepurselady]

Dear Doctor,

Thanks so much for your response sincerely!!, I think I errored somewhat in my question as I stated his blood sugar is low when he checks it, actually I meant to say its in the normal good range and not high! (107 give or take a  few points is his average)

He said the other nite he was awakened with just a general sick feeling.  He complains of this more now, just not feeling well is how he explains it, he said he was actually dizzy also. He got up and checked his suger and it was 170 (high for him)

The other thing that concerned me was how he mentions these palipitations that will come on, just a thumping, but it can go on for long hours, and when it passes, he just feels worn out.  He said it will just come on out of nowhere, example:  he will be sitting in front of the television at nite, and bammo, this attack hits him, no rhyme, no reason.  He has a mild xanax perscription but barely ever takes them, but when this type of attack hits him, if he takes half a xanax, (it has to be in the beginning of this attack) then it will sort of ease it before it gets full blown.  he says this is not an often occurance.  Could this be part of diabetes or a more serious heart issue? the palipitation thing has been ongoing for some years now, and has now turned into maybe a 2 times per month thing versus maybe 2 times per year in his younger age

As a professional, what would be the standard protocol in handling this patient, such as what tests would be recommended, would you be concerned of a heart problem?  And last but not least can listening to the artery in the neck and listening to the chest give good information as to possible blockage?

I thank you in advance for your time in answering this, I know it can be complex, and vague  but your time and efforts are much appreciated out of your busy schedule.  Its a fantastic service your offering so many people!!! Wishing you a great evening

GT

[CCF-M.D.-RCJ]

thepurselady,

A "standard" workup for this very unique set of symptoms is not easy to define.  I think that many physicians would check an EKG.  An echo might be ordered if no previous assessment of your Dad's heart function had been performed.  The nighttime palpitations followed by fatigue could certainly be short runs of atrial fibrillation, or some other arrhythmia.  Fortunately, this can be easily checked for by a holter monitor or event recorder, which will obviously require a trip to the doctor.

Also, ask your Dad to check his blood pressure and heart rate when he has one of these episodes.

Best of luck.