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Tachycardia after 2 surgeries
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Tachycardia after 2 surgeries

Hi everyone,
                    I had a gastric by-pass in 2001 with no stomach or intestine problem for 9 years... but problems start last year when suddenly I start having constipation insistead of the diarrhea that I had for almost 9 years in a row linked to the gastric by-pass. I also start having on and off intestinal obstruction symptoms, I was ok for 1-2 weeks and in pain for 1-2 weeks. Anyway,  I had a CT-Scan last april for my intestine and the Doc see nothing, I didn't had intestinal obstruction at the time, but since it was on and off, I think the day I had the CT-Scan my intestine was ok. Also, I loose 60 pounds in less than 6 months, I wasn't able to eat normaly without being in pain.

I start having a real major problems with my intestine last october and I had 2 surgeries in less than 1 week to repair the intestinal occlusion I had. Yeah, this time the CT-Scan before the first surgery show the intestina; obstruction clearly. After several months of complaints, pain, constipation and other symptoms, they also see that I was in a malnutrition state, so they instal a jejunostomy for enteral feeding when I had the second surgery. At the hospital I had IV feeding for the first 2 weeks and they switch me to the enteral feeding (Peptamen 1.5 - Nestley brand) 1 liter by day, so around 1500 calories and a lot of vitamins.

At the hospital I start having a constant fast heart rhythm, me who had a slow heart rate of 50-60 before the surgeries, I find out that my pulse rate was and is still always higher than 90-100 at rest ( if I lie down or just sit it's 90-100 but can be higher than 120 in my bed at night). When I get up the heart beat is faster and can go up to 140-160 and stay in that range until I sit or lie down again. I also feel my heart beating very hard and fast in my chest and have chest pain as well.

I ask my Doctor at the hospital about those problems and he call my Cardiologist and ask him to see me before I leave the hospital to have an untrasound of my heart to see if the malnutrition state don't damage my heart. The main problem is that my Cardiologist was out of the town for 3 weeks so I never see him. Of course when I leave the hospital to return home they give me the phone number of my Cardiologist and I try to reach him since 3 weeks, I call every 2 days and he never return his phone call!!! That's so frustrating... He probably think it's all related to my anxiety disorder (general anxiety, panic disorder) since I had a lot of normal EKG results, normal treadmill test result, normal holter 24 hours monitor result... I try to explain to him on the answer machine that since my surgeries I don't feel ok, my heart rate is too fast, I fell dizzy and can't sleep at night because of the fast heart beat but he never call me back. My hands are also turning blueish often and sweat from my hands a lot. I sweat also a lot at night and wake up cover of sweat every night with a very fast heart beat...

For now, the only meds I take is the Klonopin 8 mg day for my anxiety (it's not working anymore, addicted since 2005 and can't stop it...), I take also 30 mg of Prevacid for my stomach since I had the intestinal obstruction (I try to stop it for 3 days to see if it was the problem or linked to the fast heart rate but it was not related to the Prevacid). I take also sometimes a beta-blocker (Propanolol - Inderal 5-10 mg ) who was ok in the past to reduce my heart rate without affecting too much my blood pressure but it's not working anymore. I try to take more of it and increase the dose to 20 mg and then 40 mg and I had a faster heart rate and my blood pressure was too low... in fact my blood pressure without the inderal is already on the low side... So I don't understand wny the Inderal is not working anymore.

Is it possible that a malnutrition state and a deconditionning physical state leave me with that fast heart rate? With that fast heart rate, I can't exercise or do normal things like taking a shower, clean up the house or climb the stairs. I'm out of breath all the time, my head hurt cause I can feel the heart beat near the 2 temples on my head and I can't sleep at night because I feel the heart beat in my chest who is very fast, never had this before...

What I can do with all of this? I see my Family Doc next week, I can ask for the ultrasound test for my heart, but is it a good idea to ask to try a new beta-blocker like the Lopressor OR try to be back on the Clonidine OR a calcium channel blocker? If so, what is the best beta-blocker for a tachycardia problem, a beta-blocker who will not lower too much the blood pressure but reduce more the heart rate? I try in the past the Atenolol who lower too much my blood pressure with no result for my heart rate. I try also the Acebutolol with the same result. The Clonidine was too much sedating and didn't reduce a lot the heart rate. I try also a long acting beta-blocker call Nadolol and I faint on it and I try also the Bisoprolol with the same result, it was too strong for me.

I'm out of option... don't know what to do and what to ask for. Don't know if it's all anxiety related or not. In the past it was anxiety related and I was able to reduce my heart rate with abdominal breathing techniques or with techniques like coughing very hard and often.. it was reducing the heart rate immediatly  but now it's doing nothing. Also, the fact that it last all day long and all night long is also a major concern. I was able to deal with 1-2-3 hours of constant rapid heart rate, but now it's too much for me...

Any idea about what to do with all of this?

Thanks;-)
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1807132_tn?1318747197
I am not a doctor and can't really diagnose but it sounds like your heart may just be reacting to your physical condition but I would definitely keep on top of seeing your cardiologist to get to make sure there is nothing more wrong with your heart and to try to find out why your hands are turning blue, a sign of poor circulation.  Seeing your GP is a good start but I would not advise you to increase or decrease any of your medicines without a doctors consent.  I do hope you are able to get to the bottom of this soon but most heart rhythm disturbances are not life threatening just more of a drain on us but go get checked out to make sure all else is fine.  Take care and feel better soon.
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Avatar_m_tn
Thanks for your answer ;-)
                                           That's possible, I mean with the high anxiety from the 2 surgeries, the fact that i'm in a malnutrition state (blood tests are ok, at least my protein level is up a little bit), the pain from the abdominal scar ( a scar who didn't heal well cause of the malnutrition state, I have some hole in my scar, one of them was big and I had a VAC machine on it...). All of this can be the source of my problem?

I also can feel my heart beat in my head, it's like a migraine BUT it's not a migraine, I just feel my heart beat above my ears and that's a kind of throbing pain, no migraine meds work to stop this (Naproxen, Advil, Triptan, Tylenol...), the only thing who help to reduce the pain and the throbing feeling from the heart beat is to put one ice pack behing my head and put another one above my ears... not very funny...

I try to drink more water as well, thinking that I was deshydrated but it's doing nothing to improve the fast heart beat and my blood pressure stay on the low side all  the time with some peak on the diastolic side when i'm in a panic mood... who don't happen often... now it's seem that I don't have panic attack but only symptoms of anxiety who last all day long and a lot of concern about my heart...

Anyway, will ask my GP for the echocardiogram, at least to see if my heart is not enlarged or have some dammage because of the fast heart beat and the malnutrition state... and before I will have the results, I will try to take it one day at time, who is not easy when you always feel your heart beat going very fast in your chest...

One thing is sure, a resting heart beat of 130 when you are lying in your bed is not normal, anxiety or not... and not being able to do normal things like climb the stairs, walk around in the house or just get up from a sitting position to a standing one without having dizziness and a 150 and more pulse rate is also not normal or acceptable for me...

I know that heart rhythm disturbance are not life theatening most of the time, but they are annoying and they scare me...
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