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Unexplained Palpitations
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Unexplained Palpitations

In March I had a series of endless palpitations that started with a buzzing feeling in my chest that lasted for about 3-4 seconds. This went away and I felt fine, but I looked up causes of palpitations and within an hour got a fluttering feeling in my chest that lasted for a couple of seconds and came in a couple of runs for about 1-2 hours.

I went to the ER and they found nothing wrong with me and my EKG only showed an IRBBB and Sinus Tach.

I went to the ER two days later still afraid and they still only found IRBBB and sinus tach.

I asked to be refered to a cardiologist and had an echo done which showed no abnormalites and a perfectly normal heart.

I also had a EKG later on and it again only showed an IRBBB.

Since then I have not had the fluttering feeling but have goten very troubling symptoms. Twice I have had blury vision for a couple of seconds and have recently felt a quick lump or pulse in my neck and chest which last less then a second and comes and goes for a couple of hours.

Also during the day my chest often feels hollow or like I am getting an adreline rush that goes up into my neck.

My questions are:

1. With 3 normal EKGs and an ECHO do you think my symptoms are indicating a serious condtion (especially the fluttering)?

2. I am particualry concerned about EP condtions like Brugada and LQTS should this concern me with normal EKGs and no history of heart disease in my family? (no realitve has died from heart disease in my family)

3. I am currently on Toprol XL and Valium could this explain my periodic blured vision?

Thanks.

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239757_tn?1213813182
Luke,

Thanks for the post. Im sure these symptoms are very upsetting.

1. With 3 normal EKGs and an ECHO do you think my symptoms are indicating a serious condtion (especially the fluttering)?

If your echo is truly negative then I would probably look elsewhere for your symptoms. With your IRBB I would make sure you didnt have an ASD or PFO on the echo and would probably want to make sure a bubble study would be performed to rule these entities out.  

2. I am particualry concerned about EP condtions like Brugada and LQTS should this concern me with normal EKGs and no history of heart disease in my family? (no realitve has died from heart disease in my family)

Its unlikely without a family history. A holter monitor or event monitor would show what your heart rhythm is during the event.

3. I am currently on Toprol XL and Valium could this explain my periodic blured vision?

Most likely not unless these happen exactly at the same time of your dose administration.

good luck
25 Comments
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Avatar_m_tn
I should also point out to the doc that during the ECHO I had the non fluttering palpitation feeling through out the test and on the 3 lead EKG I could see the tracing was abnromal. I was wondering if the EKG tracing is recorded on tape along with the echo and doppler? Because the technician didn't even say a word during the entire exam.
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Avatar_m_tn
Luke, join the crowd, assuming what you have are PVC's. The doc's consider them benign if you have a structurally normal heart. Those of us who have them know that they suck. Symptoms vary widely, some people have tremendous problems (pain, anxiety, panic, etc.), others don't even know they're having PVC's.

The real problem is that there doesn't seem to be any coherent way to reduce them or to predict their frequency. Some people report reduced PVC's with beta blockers, dietary supplements, exercise, and diet changes. Others try the same thing and get no results. The doc's don't seem to be able to do much.

What most of us do is learn to live with them. I just went a year with zero PVC's - then they started up abruptly about a month ago. Now, their tailing off - but they could be back tomorrow. I don't let them stop me or make me freak out. I just keep doing what I want to, and adapt as a I can. In my case, they bug me so much when I lie down to sleep that I can't go to sleep - so I take Ambien. If they disrupt my morning exercise, I exercise later. Just figure out how you can work around them. You'll get lots of support here, I figure about half the group that posts here are PVC sufferers!!
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Avatar_n_tn
okay, question for the doc.  I have had PVCs or PABs or whatever they are calling them now for about six years.  I understan it is mostly benign.  I suffer from acute anxiety, just went on meds (klonopin and paxil, klonopin till the paxil kicks in and then a quick wean off I dont need any more problems LOL).  My question, is this.  I stay off and I mean OFF of the caffeine, smoke only lightly, drink even lightlier (i know that not a word but it describes it) but on labor day weekend my niece stayed over for the duration.  We had lots of fun, no stress, but Monday morning (labor day) She and I had gone to the store and she got a Mt. Dew while I got a Sierra mist.  Let me tell you, the same damn bottle.  Inadvertantly, I drank down (in about four seconds) her entire Mt. Dew thinking it was my Sierra instead.  Mistake.  Two hours late I am being picked up by EMSA with a heart rate of 338 BPM.  No feeling in the arms, totally on the ground, unable to help myself or get up.  Niece called 911 (I thought I was gonna die, of course, I have anxiety and an arrythmia, thought it was the end) Well they work me through several rounds of Vagals before they gave me propanolol (I think) to get me to normal.  We go the the ER and do the usual, EKG (normal) Holter 24 hrs. (several PABs, one "blocked P" nothing to worry about) and I can't find the cause of this seemingly "out of the blue" thing untill later when I spy the innocent bottle of empty Mt. Dew and remeber grabbing it and drinking it, thinking it to be caffeiene free Sierra.  So I think, okay, that was it, MUST stay off of the caffeine no matter what, that was TOO scary to ever repeat.  So, no caffeine.  Anyway, this past Saturday, I am doing my eye makeup with my fiancee downstairs and I feel the same thing...a string of PVCs (PABs? Skipped beats?Extra beats? Whatever..) and then BOOM. Tach.  Just like that.  No caffeine to blame, no stress...taking my klonopin and my paxil...lots of water, exercise, doing my cardio (which i am sure is gonna kill me ) in short playing by all the rules.  So I totally scare the **** out of my fiancee and say, hey, we got to go to the ER I am in tach...at which point he takes my pulse (we are both RNs) and he says, okay, vagal, hold,please, okay release, pulse again...too high for him (or me ) to count.  Do the Vagal several times on th way to the ER, finally it slows as we get there. Didn't go in.  What could be the cause of this unexplained (and unagitated) episode? I am only 29 and in perfect health (with the exception of that pesky heart).  My cardio guy says nothing is wrong.  Looked at EKG and 24 hr Holter.  Can't  find a thing. What could bethe cause of these "episodes"? Only makingthe anxiety worse.  Just trying to only have one problem at a time, LOL.
Melissa
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Avatar_n_tn
I am so glad to have found this site today!  I'm 31 y/o man who was told 3 wks ago that i have pvc and pac (after 2 er visits and 1 stress test}.  I seem to get these skipped heart beats accompanied by "heart hiccups" whenever i start moderate physical activity (i.e. jogging, tennis, or just playing with my daughter at the park) and also out of the blue some evenings esp. after a beer or a large meal.  I never felt these things b4 a month ago, and the first two times I became short of breath with chest tightness and a feeling of impending doom!  I was convinced that i was going to die and became afraid to do any physical activity because I know that "they" will come.  I've become very depressed, have gained 7lbs, and feel as if my doctor
is treating me like a psych patient.  He says that i should ignore the PVC's and resume all physical activity without restrictions.  He gave me a prescr. for valium 2mg as needed, and that was the end of my last appt.  I feel like there should be more tests done but i also feel like a hypochondriac!  Does anyone else get pvc's (somtimes up to every 5 to 10 beats) durring light or moderate exersize?  My mother said that her doctor said that hers (PVC'S) were harmless because they did not get worse with physical activity. Is that true? I seem to get them almost exclusivly durring exersise.  I feel better already just reading all these comments from others with similer symptoms>  thank you so much,
    maybe I'm not dying, lol
             Joe
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Avatar_n_tn
Wow, sounds like my story.  I to am 31y/o.  My PVC's came out of the blue almost a year ago now.  Happened over the Christmas holiday.  I got myself so worked up that I had an anxiety attack and wound up in the ER.  Cardiac workup normal. Had to wear a cardionet home heart monitor for three weeks.  Exercised while wearing it vigorously and was given the all clear after 3 weeks of home monitoring.  I was fine for a couple of months and the PVC's returned.  Back to my doctor.  By this point I'm scared to death.  He sends me for an echo and luckily while having the echo I had a run of PVC's. Was told begign PVC's was switched from Atenolol(on for mild HBP)to Toprol XL and things have been going pretty well.  I think I still have the PVCs but I don't feel them as much or if I check my pulse.  I walk/run almost everyday and I have found this to do wonders.  I also just started paxil.  Everyday is a struggle, but from what everyone says, they won't kill you.  Just have to have faith.
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84483_tn?1289941537

I have exercised induced PVCs also, but I can have them at rest also. I had them before , during and after an exercise stress test (Bruce) during my worse attack ever. After that I was more reassured that I would not drop dead from exercising with them, it is very hard to do , but the best thing is to just keep on going and try and ignore them, I know that is difficult when it feels like your heart is out of control and is basically going to stop.
  
I take atenolol and I find that it helps to suppress them most of the time. I think in last 15-20 years alot has been learned about PVCs regarding their impact on one's overall prognosis regarding longevity, with a normal cardiac evaluation it is no different from the population that has very few or completely asymptomatic with them. I turned 41 just today and have had them since I was teenager, to be honest when I first experienced them so severe and frequent I thought that was it for me and that's been 20+ years ago and Im still going strong.

If you have no other serious health problems and only just PVCs to worry about (no to say that they are not alarming), hang on tight you're in for along ride, nothing bad will happen to you. Take care and good luck.
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Avatar_n_tn
Since pvcs are "benign", they won't kill you, but they will rob you of life if you let them. They are hard to ignore, I get them all day long, every day, less now, maybe 1000/hour. But I take great care, all day long, every day, to recognize how special the world is, my world is, my life is. Takes great effort and practice. But I can either dwell on the positive, or dwell on the PVCs.

PVCs will come out of the blue, and may leave just as unexpectedly. But if you are watchful of them, you will indeed see more and more of them. I'm in a fortunate place right now, they don't bother me too much. But I've been in states of panic where I thought the end was near. Hope you find some relief in what ever way possible. Keep looking for solutions that fit you. I find enough water, enough rest and enough activity help me.
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Avatar_n_tn
Sorry to take up a post, but I had to wish you a Happy Birthday. On my birthday this year, I had one of those days where I wondered where the PVCs went, they almost stopped. It was glorious. Didn't last, but it was such a nice present. Hope the same for you.
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84483_tn?1289941537

Thanks. To be honest besides the occasional thump now and then, its been 4 years since my last bad attack that lasted for months in the 1000s daily, hope it keeps like this for a long long time and ill be just fine as far as PVCs goes. Take care.
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Avatar_n_tn
thank you for your responses.  I went joging last night  and immediatly began getting pvcs maybe 10per min ( i feel them in ny throat when im running) I was able to run through them and didnt stop until I was exhausted, I felt great afterwards, like a small victory over my own fears.  I'm still worried that i should be getting wore tests to be sure i have an otherwise healthy heart, I've had and ekg, and a treadmill stress test.

Should i insist on more? thanks again.
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84483_tn?1289941537

If your Ectopics beats PACs/PVCs have been captured either on ECG or treadmil test and you know for certain its PVCs, then a holter monitor is probably not necessary, at least when my cardio documented mine on ECG and then on the Bruce exercise stress test, he told me quite frankly that to do a holter would only add extra expense for nothing, unless I was experiencing different beats or symptoms, I call that being very honest and with the patient best interest at heart.

The only other test I could think of would be a echocardiogram to make sure your heart is structurally normal, it can give a fairly accurate view of your heart valves, wall dimensions and thickness,overall heart size and a good estimate of your ejection fraction, its like the icing on the cake.

I've bee told by my cardio that a stress test,ecg, holter( if your arrhythmia has not been caught on ecg or stress test)and echocardiogram is the basic tests needed to evaluate frequent and bothersome pvcs, if everything checks out normal with these test , then its probably a less than 1% chance that the arrhythmia is occuring because of any serious heart problem or disease. Good luck.
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21064_tn?1309312333
Ditto on tickertock's comments.  You may want to consider an echo just so all bases are covered.  If that comes back "normal" your "condition" will likely be referred to as "benign."  That being said, they are definitely not considered benign to those of us who deal with these pesky buggers.  But, once you have been deemed to have no cardiac anomolies, it may help to cope with the anxiety. When our hearts are involved, our anxiety kicks into high gear and it becomes a tug of war with mind over matter.
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Avatar_n_tn
Hi everyone.  First off I'd like to thank everyone for their posts and support.  It helps immensely to know that I'm not alone.  Here's my story.  

My condition began with panic attacks resulting in palpitations.  I've had them since I was a kid and learned to deal with them.  They also only happened at night.  About two months ago they started happening randomly.  My pulse upon awakening in the morning was usually between 50 and 70, but one morning I woke up with a pulse close to 100 and it really scared me because it remained there for a while.  It only got worse from there and my lifestyle changed drastically from athletic to sedentary.  Any slight exertion would cause my heart rate to jump to 130+.  I saw a doctor and went through a series of tests...EKG, Holter, and Echo.  The EKG showed a few premature beats, and the Holter showed sinus tachycardia, sinus bradycardia during sleep (I was on a beta blocker at the time), ~4000 pacs, infrequent pvcs, and normal baseline rhythm.  Overall I was told not to consider myself a cardiac patient and was diagnosed with anxiety disorder.  I was prescribed celexa and have been taking 20mg/day for over 6 weeks now.  I don't feel much better.  

Recently before climbing a flight of stairs I went into a panic attack and my heart rate jumped to 180.  It had never gone that high before so this really scared me.  Twenty minutes later we were in the hospital parking lot but never went in.  My pulse finally dropped below 100 half hour later.  I can't explain why it takes so long to return to normal.  I've had a few more episodes since then.  

So here I am today.  I wake up in the morning with a speedy pulse that doesn't drop until a few hours after awakening.  Even then slight exertion raises it.  I just can't accept that this is all due to anxiety.  My heart is like a switch.  It'll be beating around 60bpm then I'll switch positions while sitting and it'll jump to 100bpm.  Sometimes I also have runs of pacs, about 5 or 6 in a row.  I feel like I'm constantly on the verge of a panic attack.  I find it hard to believe anxiety is causing this.  I haven't exercised for over two months in fear of raising my heart rate and going into panic mode which, in turn, would raise my heart rate even higher.  What can I do?  Why is my heart rate so dynamic?  I'm still on 20mg/day of celexa and take lorazepam as needed for anxiety.  Should I increase my dosage of celexa?  I just want to go back to the way it used to be.  I'd give anything to go back to the nocturnal panic attacks.  I could at least deal with those.  

Sorry the posting was so long but I wanted to air it all out.  I appreciate anyone taking the time to read my story and offering any advice.  I wish you all the best.  God bless.
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Avatar_f_tn
Hi - I have anxiety attacks, too.  I have heart rate variability too and I'm on a beta blocker.  My HR goes down to about 48 when I'm really relaxed or sleeping and can jump to 130 or so when I'm anxious.  I've been at the ER with an HR of 160 when I was having a severe panic attack.  I think it's normal for someone's HR to jump up when you're anxious.  I've dealt with this all my life and it's miserable worrying about your heart all the time.  I'm still trying to accept the fact that it really is just anxiety and get on with life.  I've had all the heart tests, too, and they're all normal.  I hope you can find freedom from the worry!
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Avatar_n_tn
Yea...I just had an appointment with the cardiologist yesterday and he came to the same conclusion - I have anxiety disorder.  I'm slowly accepting it.  It's just the variability in heart rate that gets me.  I think I'm slowly coming around though.  Thanks for the response.
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Avatar_n_tn
I'm a thirty-one year old male, I have been having fluttering sensations and feelings like my heart is going to stop for about the past year and a half.  Occasionally I would get pain with these "attacks".  I've made multiple trips to the ER with everything checking out normal.  I've seen a cardiologist and have taken almost every stress imaginable, all of which came back negative.  The only problem that was uncovered was my cholesterol was very high, I was put on Crestor 10mg and it came back down.  I still have these awful sensations of fluttering about once per month, which now trigger panic attacks, I really don't get the pain so much anymore. I occasionally take Xanax .25 but it does seem to matter since these feeling have a mind of their own.  I wish I could have my life back, I am constantly worried that I am going to have a heart attack.
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Avatar_n_tn
I'm 23 years old, and began experiencing a weird feeling in my chest (towards my left shoulder), a fluttering and a slight stomach sinking feeling every few heart beats. With this, my heartrate was pretty fast..about 85-90bpm.

At the beginning of the week I had a cold virus of a sort where my thyroids glands were swollen and was feverish, but recovered from this after a day. The next day from this recovery, I had a slight episode where my heartrate would increase all of a sudden, and my neck tightens up, and have slight trouble breathing. That night as i was tryign to sleep, it happened again and my heartrate hasn't really slowed down since. (I has been 3 days).

I've been to the hospital and did a few ECG tests, a blood test and a urine test, which resulted in the doctor concluding to a supposed underlying anxiety.

What I don't understand about this is that I am sure that I have not been stressed for weeks now. I haven't drank coffee in months, only teas. I am not a smoker, nor have I been taking any medication or drugs of any sort. I'm not overweight and I feel that I eat fairly well.

The only explanation is that my family has a history of heart disease. Other than that I am puzzled and I can't take 'underlying anxiety' as a final answer, because I've scanned my mind and cannot find anything that could cause my body to react this way. Although, my chest fluttering all the time just from lying down and relaxing, is making me constantly worried.

I'm wondering if anyone can shed some light on this or have any suggestions...?

Thanks
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Avatar_n_tn
Hi Jade.  I can't say that I have the same fluttering sensations that you do but I think we're in the same boat in that we can't accept that what we have is anxiety.  Well, I've seen three different docs and they all concluded I have an anxiety disorder.  I had a normal echo and from what they say it's pretty conclusive.  I still have episodes now and then and am still afraid to over-exert myself, but little by little I'll get there.  I think if you've had an echo then you can rule out any heart problems.  I know it's hard to accept though because you constantly feel the symptoms.  Have you had your thyroid checked?  I think I can speak for everyone here when I say we're pulling for you.
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Avatar_n_tn
Hi everyone, I'm new to this site but it already has helped me feel a little better.  I started having what I think is panic attacks back in january of this year. I went to the ER and had an ekg which showed palpitations. The doctor assured me they were common and normal. My blood test showed my magnesium level really low so i started taking suppliments. I followed up with a cardiologist who did an echo and said my heart is normal. I would have a panic about about once a month sometimes not even that often. Well I just recently had a sharp pulsating pain go from my neck to my shoulder and even spread to my back. It lasted about a minute. I went to the er and they said my x-rays and blood work were normal. I again had an abnormal ekg which showed palpitations. The doctor assured me it's probably just anxiety and said i'm too young for it to be a heart attack. (i'm 28) I'm just not comfortable with the answers i get. I feel like the er doctors are just brushing me off. I have no insurance so I can't just go to a cardiologist with no money.
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Avatar_n_tn
prjose56 - Thanks heaps for your reply and encouragement. I think like kristylu says, I feel a lot better having found that these are common.

Perhaps doctors need to pay attention to how they can help diminish one's anxiety instead of creating more grey area, and if worse still, creating more anxiety!

My heart has since calmed down (it has been a 2 days), and I can forget about it. But I still worry and am very conscious of the things I am doing and eating day to day. I've also recently joined the gym, and hopefully this will improve whatever condition i supposedly have!

I'm to return to the doctor to do another check on my thyroids, but for some reason, I am not entirely confident that he will give me any suggestions or precautions about my heart - probably again tell me that everything is 'Normal' and that everything is fine.

Ive just been trying to improve myself from here..theres nothing else to do...aside from work at being positive, try to be calm, eat healthy, drink lots of water, exercise - all that stuff. I'm beginning by taking walks, stay active even if it's not too streneous. I'm probably straying too far from the original topic now...but I just hope in a way it inspires people to be distracted (if not get better), instead of being caught up in worry all the time. (easier said than done i know...but all it needs is a small start).

Best to everyone...
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Avatar_n_tn
I have a question for anybody are PVCs and Palpations the same thing????
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84483_tn?1289941537

I have been explained by my cardio that any awareness of the heartbeat whether it be fast, slow, irregular or regular is referred to as heart palpitations, so in short in PVCs are palpitations once you are aware of them, if you are not aware of them they are simply referred to as an premature ventricular contraction or ectopic ventricular beat that is asymptomatic to the patient, in other words an irregular heartbeat without symptomatic palpitations at least this is how I understand the definition of heart palpitations.Hope this helps a bit.
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Avatar_n_tn
I am 35 years old and have been having flutters since 1998 while exercising. I was told this is normal.  I have PAC's and PVC's and a feeling of skipped beats along with pressure in my chest and pain in my left shoulder and down my arm.  I have had extensive workups by three different cardiologists, EKG's, Stress test's, Echo's, Stress Echo's, Holter monitor's, Event monitor, Blood work, you name it.  Everything seems to check out fine.  I do have a family history of heart disease in my family, so I was very worried as both grandparents and mother have had and died from massive heart attacks. I was told that when it happens do not get alarmed, if so, it will raise your adrenaline and can get much worse.  They did find that I had a thyroid problem, I am(Hypothyroid)which can cause some of these problems along with being tired and so forth.  I still have them but not as bad as long as I take my Synthroid and keep my thyroid under control with my Endocrinologist.  Maybe this will help someone.  I would advise a more extensive workup if you are not satisfied with your physician's answer.  MY THEORY IS (just because you hear a gallop in the park doesn't mean its a horse, IT COULD BE A ZEBRA) Meaning - not every patient is alike and when you treat every patient alike then problems can happen per MY DOCTOR.  I have a trace of mitral regurg and was told that 9 out of 10 people have this and it is normal.  Everyone has some skips, but when we sensitize ourself to it then everytime it happens we feel it and worry.  Try to go on about what you are doing and take deeps breaths, it really has helped me.  For everyone - take care.
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Avatar_n_tn
hi my name is marcy and since august I have had palpitations for no reason, I do have panic attacks and am on a low dose of vistiral and a high blood pressure pill , I dont know why these have started , I have been to er several times and have had normal ekg's and a couple times my potassium was low and doc said that could have cause me to have pvc's , I have wore a holter and that was normal I am really scared and when it happens I panic and that just makes it worse, mine mostly happen at night and lasts about an hour or two and then goes away I try to ignore them but its hard to do when you feel everyone of them skipping and feeling like stopping and then going fast I am going back to the doctor today to have somemore test done so everyone say a prayer for me I love this site and have been reading everyone's comments so I know I am not alone and I appreciate the support thanks I will post later and give everyone an update on what my doc says today everyone take care I will keep you in my prayers , god bless...... Marcy
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