Trigeminy

[ozmi]

I went to my Cardiologists office today - didn't get to see him but an EKG tech who conferred with another doctor to inform me that I have Bigeminy and Trigeminy.   I have a sensation of pressure in my chest due to loss of breath, feeling dog tired, and just overall crappy.  They told me that the scar created by my heart attack at the end of September is probably producing the problem.  They ever so casually informed me that it MIGHT be helped if I got a defibrillator implant, from which I might feel shocks from for the rest of my life, "Have a nice day, and we'll see you on your next visit."  I didn't take that news well.  I'm 41, The thought of having to endure this described quality of life for the duration was disheartening to hear to say the least.  ANY help would be most sincerely appreciated.  I have NO information on what this is, possible treatments (beyond an implant), or future expectations.

[Danamac]

I recently had a Nuclear Stress test because I have Bigeminy, Trigeminy. I have family history of heart problems. Most of my family on my fathers side died in their 50's from heart problems.  My brother lived to be 60 and had SCD.  I started having, what I thought were skipped beats when I was in my 40's. They have increased over the years and I am exhausted from them. I stay away from doctors or at least try to but this time I am really concerned about what is happening to me.  I can't keep up with our busy life style and get so tired. The stress test came back normal , but the Ventricular B & T are always there. The doctor told me that if I black out to let him know. I read that these symptoms are no big deal and others say the opposite. I am very concerned.  

[ozmi]

........to you also.  Thank you.

[banglamom]

Don't give up on playing with the kids.  Do they understand you have a heart problem?  Mine do.  Playing with them doesn't mean wrestling anymore.  I read stories, sit with them on my lap, paint my daughter's nails, discuss lego creations with my son... find ways to get into their world and still be comfortable.  We have trouble sometimes too with being upset when I don't do something right and things go sideways (as we say).  Often, I don't say anything anyway.  When my husband asks what's wrong, I just say engine knock.  It's been years and since I haven't died (or at least I'm not STILL dead), I actually worry about it less and less.  I don't go to the doctor when I have a rate of 200.  I don't call the doctor when I have a bp of 60/30.  I have great insurance, but I don't like going to the doctor.  He never has anything to say that I WANT to hear, so I only fo when I have to.  That is when they call and say, it's time.  The problem isn't going away, so you have to find a way to make it fit in your life however you can.  Blessings to you!!  I wish you peace in the journey.  Keep up the conversation with God and keep communicating with your wife.

[ozmi]

I tried to play with my kids today.  They like riding on my feet as I walk around the house.  That usually leads to wrestling.  I had to stop.  The trigeminy kicked in, and big.  I couldn't breathe.  My bp was great; but I felt like I had a hippo sitting on my chest.  My wife got worried this time - that lead to angry.  You know, that fear angry.  Blaming me for not being more aggressive about getting answers from my cardiologist.  I have no control over how fast he works, and she has even less.  With no health insurance, I'm lucky to have a doc that'll see me.

[banglamom]

This year has been very hard on my son too.  He (and my husband) are always afraid that I will not live through the night,...  My son is 9 years old.  I have tried to shield him to some degree from the severity of the situation.  He is tender too.  I worry about him.  My daughter just turned 6 and she is happy all the time and totally oblivious to it all.  I'm glad.  When I have to rest sometimes though, she is the last one to let me get any rest.  She'll come with an "emergency" like her cup is empty.  I had already got life insurance before this was a problem.  I can never really change it or increase it, but I think I can pay it forever like we originally bought it.  I wore one of those event moniters for 3 months last year.  You MAY live to be an old man, but live today like THIS is the day you want your children to remember you by.  Sometimes my energy is limited.  If I only have a bit of energy each day, I try to spend it with doing fun things with them.  I don't want them to remember me as a tired crabby lady who just did a lot of laundry.  Have a great day.  It is past my bedtime now (since I'm nocturnal).  Good night.

[ozmi]

I hope you had a good night at the office!  I'm on my monitor today - wearing out the lil "event" button.  I'm looking forward to some answers, and if there is a solution or NOT.  Funny, since my heart attack, I'm not afraid of death either, I've kind of accepted that it may or may not be eminent.  It's my wife and kids I worry about.  I'm just angry at myself for not having protected them.  I didn't secure life insurance before the attack; now I can't get it - or afford it, since I've not been working for so long.  I always squawked about how important it was to me to get it; but I didn't.  Now I'll need at least one uneventful year, they tell me, before I might be eligible to get anything for my family.  I'm really close with my kids.  It'll be crushing to them.  That's the part that saddens me, visions of how they'll take it and who'll help them adjust.  My son especially - he's very internal with his thoughts.

[banglamom]

No ICD, I have had no shockable rhythms.  However, next pacer may be different.  There are pacers that can do anti-tachy pacing.  Heart goes fast, pacer goes faster... captures the rate of the heart running away and slows it back down.  Amazing.  I love my pacemaker, in part BECAUSE it takes away some of that terror that I will stop again.  Never before has something been able to bring such reassurance.  That and my relationship with God.  I am not really afraid of dying, then there is heaven.

I too struggle with exert myself and start to go lights out, because my heart wants to go 200 but the meds don't let it and the pacer only will take it to 130.

More later... off to the shop.  (Night shift on the cardiac surgery floor at the big medical center)  Blessings to you!

[ozmi]

Thank you.  Yes, It clears up a lot.  So you actually arrested?!  Wow!  I tought I felt fragile!  That must be perpetually scary for you.  I can't imagine what it's like to live with af.  With my trigeminy, I only FEEL like I'm going to die any second(nauseated, sweaty, light headed, I get really pale, and can't think clearly); but it goes away for a few minutes and I feel better, then, soon, it returns.  This occurs over and over all day now.  Mostly when I exert myself slightly.

I had no idea a pacemaker could be so specifically talored.  I learned today that defib implants are installed after your nerves are cut.  Is the same true for a pacemaker?  Do you have both implants?

[banglamom]

Sorry about the language... I speak nursing.

vf- ventricular fibrillation; the lower part of the heart has more like just quivering than effective pumping.  It is absolutely ineffective and immediately life threatening, a "code" that a patient haas to be DEfibrillated (shocked) for.

vt- ventricular tachycardia (the lower part of the heart going too fast)  Often vt is 250-350 beats per minutes and involving only the lower heart.  Sometimes it can be fixed emergently with drugs, but often has to be shocked.  Those are the only 2 rhythms that are actually shockable for cure.

syncope is usually a long pause that makes people fall down, black out, pass out.  With my arrest, it had been syncope, syncope,... then NO more heart rate at all with no blood pressure.  It is cardiac in origin.

cardiomyopathy means dysfunction of the cardiac muscle.  cardio (heart), myo (muscle), pathy  (problem)  (think like sociopath).  The heart muscle usually tries to compensate and then gets bigger and bigger as it gets less and less effective.

My pacemaker is "rate-responsive".  That means it can speed up as the demands are increased.  Incredible.  If I am moving long bones, it senses the movement and speeds up.  If I am breathing faster, it senses the need and speeds up.  This thing is AWESOME!  The limits are programmed into the wee computer.  I have had some problems of it not speeding up fast enough and getting woozy, last couple times, I was shoveling snow.  If I had too much problems with that, I would go get a pacer adjustment.

As a nurse, I certainly don't WANT to have empathy for everything my patients go through.  Being a patient as well as a nurse, well it can work both ways.  I can teach, teach, teach.  Sometimes though, I don't have a lot to offer for reassurance.  I have been a long example of what happens if it doesn't work out.  They don't want to hear that.  When it comes to heart failure, I am So sympathetic.

Hope that helps you understand some terminology and clears up some things for you.

[ozmi]

A brand new member, and already I've been exposed to a ton of terms I've never seen!  What is syncopal arrest?  Cardiac or cerebral?
bradycardia is a new one on me; vf (fibrulation?) vt (tachycadia?); and cardiomyopathy (Oh boy!)
How does a pacemaker work when you exercise?  Does it hold back your heart rate, and would you get light headed/prematurely tired from a lack of sufficient blood flow?
I'm also curious to know how your approach to nursing has been affected by your experiences as a patient?  I would guess it's great to be cared for by someone who truly gets the big picture.
The tech meant well I think; but she is young doesn't have the rest of the experience to handle my questions that followed, or a clue how it would make me feel to hear her diagnosis and treatment as a 41yo father of 8 and 6yo children who has to work in a physical career to support them.
I have a new symptom that started yesterday.  When I laugh, I am geting a deep pinpointed pain to the left of my sternum that feels like a bruise.  Ever heard of that one?

[ozmi]

Thanks Brooke_38.  Yes the EKG was what determined the trigeminy, and the mi is apparent; but they have yet to tell me how severe or mild my damage is.
Is your new problem cardiac related as well?  You seem to have the same issue with your doc dragging their feet on solutions as I do.  You get a diagnosis, a "Lets wait and see.", and then months go by before the next determination, more time for a possible solution, and more for the actual solution.
I read your bio, and copied your 101 stress relievers.  That's great, I'll be sharing that as often as possible.  After my heart attack, a number of my friends got checked out to find that either their bp or cholesterol is high, or both.  I'm sure they'll appreciate it.  Thank you!
Also, I have a pic with my wife and kids, almost identical to the one you have posted, taken off of I70 in CO. from about 4 yrs ago.

[banglamom]

I have had about every rhythm EXCEPT vf  and vt, the worst ones (yeah).  Almost nothing could help.  Now I take obscene amounts of meds.  They really slow down my heart.  I was having bradycardia when they finally could slow it down.  It was decided that they would pace me and med treat the rhythms.  If I don't take the meds, the rate is nearly always 160-200 without much activity at all.  On the meds, I am 80-90% paced and not beating my heart to death.  The goal is that it will last longer.  The wacky rhythms are caused by scar tissue of the back of a horrible viral infection.  You can read a "bio" of my cardiomyopathy on the heart disease forum.  Look up virus as a keyword.  It is certainly different than having a heart attack, but trouble of another kind.  Good luck.  Find a dr with a better bedside approach.  Iy yi yi!  Actually, it was a tech, huh?  If you turn it in, he would/ should be disciplined.  That was way out of line.  

[Brooke_38]

Hello...

I just read your original post about how they "ever so casually informed me that it MIGHT be helped if I got a defibrillator implant, from which I might feel shocks from for the rest of my life, "Have a nice day, and we'll see you on your next visit."  

That is a terrible way to leave your appt...sounds like you left with more questions then answers! Have you had a recent Echo to determine the extent of damage as a result of your MI? I can relate to being young and filled with uncertainty to what the future holds.

I was scheduled for pacemaker implant in Aug for Afib but during the procedure another problem surfaced which resulted in postponement of that. So now I'm in the lovely land of limbo...not a fun place to be, but things could be worse I'm sure.

I do hope that you get all your questions answered by a Dr willing to give you the time of day:)

[ozmi]

Thanks banglamom.  My MI was in my right artery which was angioplastied.  Two months later my left was stented.  Cardiologist only said it was mild, but refused to predict loss of heart function in percent loss or any other way.  I didn't notice a low heart rate until about a month ago (1 month after stent insertion).  I have no idea if I'm fully rehabbed or not.  No one seems to want to tell me what to expect.  I'm self employed, and without insurance, so doctor choices are severely limited.  The implant would continually shock me all day long according to the tech I spoke with; but my doctor still has not advised.  What did you have that prompted a pace maker?  Did you have fibulation?

[banglamom]

How bad was this heart attack in September?  They DO cause damage I'm afraid.  Just having lived through it in September does not necessarily mean you are out clean.  If you do have to end up getting an implant... that is MUCH better than needing a TRANSplant.  I am 41 and had to get a pacemaker  this year which I actually come away recommending.  My problems are also just leftovers- scar tissue through my heart after a big viral cardiac infection... 15 years ago.  Has it been getting worse or are you still not as fully cardiac rehabbed as will get?  A lot of people with defibrillators never even have them fire.  Very few go about getting zapped regularly.  Understand that each time a shock is delivered, it has saved your life might make it a bit easier to tolerate.  Also, each time a shock is delivered, it's md time.  It could very well be that some may be managed with medicine.  I hope you have an appt soon with your md.  In the meantime, don't get too hopeless.  You are not at this point doomed to a lower quality of life but you will forever have to factor in the heart attack in your own personal history.  I hope it goes well and you come out feeling encouraged.