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PVCs and Turning pale, cold, and shaking
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PVCs and Turning pale, cold, and shaking

For the last 3 years, I have very frequent PVCs (37,000/day) with thousands of bigeminy and trigeminy runs, a few dozen V-tach runs.

Lately, when the episodes are very bad, I suddenly turn noticeably pale, my face and hands get cold, and I shake a little. It lasts for 5 minutes to half an hour. What is this? Is this kind of reaction due to the PVCs or V-tach? I don't have issues with hypoglycemia, and haven't changed drugs lately. I

The docs have recommended an EPS and/or ablation, but I don't have money or insurance. The stress-echo showed that the ventricular ectopy gets worse in the resting & recovery states. I black out if I try to exercise. I take about 100mg Atenolol a day, but it doesn't work well, like the other 6 drugs I've tried.
Tags: PVC cold pale shaking ectopy, PVC, Cold, opalescent, pale, shaking
11 Comments Post a Comment
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Avatar_f_tn
37,000 per day is a LOT, and it sounds to me as if you are suffering a drop in blood pressure due to inefficient pumping.  How's your left ventricular thickness?

You have some kind of insurance that allows you to get evaluation by cardiologists.  Have you talked to any of them about emergency coverage for the needy?
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1807132_tn?1318747197
I read your profile and see you believe you may have been exposed to some fumes at some point.  Have your lungs been evaluated?  I also see that you have stress and anxiety.  I would work to try and get government assisted medical insurance to hopefully get approved for an ablation at some point if this continues, but until that happens, I would continue to put a lot of focus and work on overcoming your stress and anxiety, these are very big triggers for pvcs.  I would also work on any stomach issues you might have, acid reflux being another big trigger.  As well I might go and see if there is any lung damage and find out what can be done if there is to help you breath better.  Addressing and adjusting those issues may help alleviate your pvc situation.  It may not make them totally go away but any relief at this point may be welcome.   Finally just take it as slow as possible.  Your heart is irritated and needs as much rest as possible.  I do hope you are able to get these under control and feel better soon.  Keep us posted on how you are.
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Avatar_f_tn
I am on worker's comp for the arryhthmia, because I only have a few hours of activity before I'm too dizzy and disoriented to continue. The WC insurance company is terrible, and I'm not getting anywhere with the doctors. One tells me I might drop dead, another tells me I'm a head case and perfectly fine, suck it up, kid.  

I do belong to a free county clinic, and they've been helpful, but there is only so much they can do without much state/federal money. The cardiologist there has also recommended ablation, but it has to be a life-threating, immediate urgent care situation before they can approve a surgery. My lungs seem OK. The free clinic system where I live (Oakland, CA) does not have any psychotherapy or psychiatry available for free (unless you 5150 into the psych ward), and I can't afford a therapist myself to alleviate the anxiety, stress, and depression.

My stomach issue is still a problem, but at least I'm not throwing up or dry-heaving every morning or so. That started when the PVCs did, and went on for over a year, until I got accepted into the free clinic. They said I had GERD and gave me 150mg of Zantac every day. I still have a lot of nausea, though. but the puking is gone.

Oddly enough, achillea, my blood pressure has gone way up, 150/100, 160/90.

Basically I'm only 40, miserable, and have very few resources to get better. **** America, **** our healthcare system, and **** worker's comp.
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Avatar_f_tn
Re: the left ventricular wall thickness, I have no idea. The worker's comp cardiologist would not explain much to me, and said only "I was looking for ischemia, and there isn't any, so you're fine." I had to look up ischemia when I got home; he wouldn't even tell me what it meant.
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1807132_tn?1318747197
It is hard to suck up to 37,000 pvcs a day. It would make anyone feel very ill.  I would say really work on your stomach issue.  Acid reflux can be a very big trigger as well for pvcs.  Maybe if you get that cleared up a bit more your pvcs will settle down as well.  Also, hopefully since you are no longer vomiting maybe your heart will get a little rest from that which can be quite a violent shaking of the chest when that happens.  So just take it as slow as possible for now and do whatever you can do to help your stomach heal and hopefully you will see some improvement.  Hang in there.
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Avatar_f_tn
Those are high BPs, all right.  Did the Free Clinic at least get you onto some kind of BP medication?
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Avatar_f_tn
PS:  The left ventricular wall thickness?  That's a rough measure of how much work your heart is having to do, and thickening of the ventricular wall *could* be an indicator of medical necessity.  I don't want to freak you out, because there's thickening and then there's thickening, but it could be in your best interests to ask what those particular numbers actually were.

The squeaky wheel gets the grease, as they say.  But boy, am I with you on the matter of health care in the US.  My son will never have a job that gives him that--and he has great need of medical care.

One more thing:  On dealing with stress, PVCs, and so on:  There is a cheap little old paperback out there that is extremely good for advice about these subjects.  It is  "Hope and Help For Your Nerves," by Dr. Claire Weekes.  She explains stuff well, and provides good mental exercises for stress.
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Avatar_f_tn
Thanks, I ordered that book. The clinic did put me on beta blockers in May 2010.Since end of 2010, I've tried atenolol, metoprolol, verapamil, flecainide, and two others I've forgotten. Some made it worse, flecainide especially. Atenolol seems to work the best, at about 50% effectiveness, although the weight gain, increased depression, and memory loss are big problems.

The high BP started only 6 months ago, and I've been treated (with medication only) for the PVCs since May 2010. I take 100mg atenolol/day, usually split am/pm. It seems to have no effect on my blood pressure at all. I can have horrible PVCs with high blood pressure, or normal, it doesn't matter. When I say "horrible," I mean being in full bigeminy and trigeminy for 2+ hours straight.

Last visit, I had taken 100 mg atenolol 1 hour before the appointment, and had 65bpm, no PVCs, and bp 150/100. I don't understand. 100mg atenolol will knock out the PVC for about two hours, but that's it. I won't remember that 2 hours, though.

Since May 2010 I've tried atenolol, metoprolol, verapamil, flecainide, and two others I've forgotten. Some made it worse. Atenolol seems to work the best, at about 50% effectiveness, although the weight gain and memory loss are big problems.

I don't want to live like this anymore, but I don't want to hurt my family. If I could only get into the psych hospital! This is Oakland, and you have to be a danger to OTHERS, not just yourself. A middle-class white girl with suicidal ideation "is not a priority."
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Avatar_f_tn
I am so sorry about your medical situation.  It IS insane that citizens who need care, especially for complicated problems like yours, simply cannot get help.

A couple of times a year, I go through phases when my blood pressure runs high, and like you, I have had no success finding a BP medication that is even halfway effective yet does not make me feel that I'd rather die than live with those side effects.  Several friends have reported some benefit from meditation or biofeedback, but I haven't tried those.

Regarding your thoughts of suicide:  It is good of you to consider your family, because families do not ever get over this kind of loss.  Those you leave behind are tormented for the rest of their lives.

However, you clearly need help.  Alameda county does have a free counseling service.  Since I do not live in this area, I don't know how extensive it is, but the service exists, and there is no charge.  They are apparently willing to address not only suicidal ideation but the effects of stress.  I recommend that you visit this site and use the contact numbers offered:

http://www.crisissupport.org/stress_counseling

I hope you can find some support and care soon.
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Avatar_f_tn
Alameda County/Oakland "medically indigent" program does have some free counseling, and there are some group meetings in various counseling organizations, but getting weekly long-term psychiatry or psychotherapy is a different matter. My social worker in the system has been trying to get me in for over a year, and finally said that it's just not going to happen. Oakland has only so many appointments, doctors, and beds available, and there are many people way worse off than me. It's just numbers; too many people and not enough resources.

What's also messed up is that the worker's comp cardiologist said "your head is ****** up" and that the only way to decrease the PVCs was with psychotherapy. But he refused to request one for me; he said "it's not my area." Legally, as my treating worker's comp doctor, he has to provide the referral if psych problems are part of his diagnosis. But he won't. I have met with 5 attorneys, and none of them will take my case, because I've been treated for mental illness my whole life. They said straight up that anyone with "a history of mental illness" will be screwed over by worker's comp, regardless of the injury. Also that they don't want a client whose anxiety is so bad that they cry under stress. And that there is no big payout for them because I didn't earn much money. I've tried free legal aid places, and none of them handle worker's comp.

Sorry, I know this is off-topic. But it helps me when I write it out. Thanks for listening.

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Avatar_f_tn
What an awful situation!  I really am sorry.

Although weekly therapy would be the ideal, it could just be worth a shot to attend some of the free counseling and group meetings.  It's just possible that this could expose you to (a) another aspect of the system, and (b) it might also offer some insight into how others in your position (or those who counsel them) manage to deal with godawful circumstances.
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