sensitivity to adrenaline

[mom25kids]

My 14 yr old son recently had knee surgery for the 2nd time. During recovery from his 1st surgery (he was 12) he became very sick and agitated and we couldn't get his pain under control. Finally after trying many different pain meds he did get better and was able to go home in 4 days. After the 2nd surgery, we initally had the same problem. The hospital gave him a double dose of morphine. When he began acting the same way as before I made it clear we would not be giving him any more and to change pain medications. This made a HUGE difference in his ability to recover quickly. It made sense to us that this was most likely the cause of his discomfort and sickness after the 1st surgery.

On the down side another problem arose. He had a pulse rate of between 140--150 for the next 48 hours. The Dr.'s weren't concerned at first and were attributing it to the morphine reaction. As his pain lessened and he began to feel better the pulse rate DID NOT return to normal. It has now been 4 months since the surgery and his knee is completely healed but he has been through some tests for his heart. A sonogram showed that his heart looks and acts completely normal, however a 24 hour halter monitor proved otherwise. At several points during the school day his rate was above 170bpm. Our Dr. has put him on a heart medication, and is having his physical therapist watch his pulse rate.

My son is 5ft 9in, 142 lbs and very athletic. Has never drank or done drugs. I'm very concerned this is going to define his life. Can you please tell me what could be causing this. Our Dr. said it could be a variation of POTS, but I have looked up the symptoms of POTS and the only 1 he has is the racing heart. I don't think this is what he has going on!!

Please let me know your thoughts!!

A Concerned mom              

[Michael J. McWilliams, M.D.]

POTS and inappropriate sinus tachycardia are often interchanged but very different conditions.  Inappropriate sinus tachycardia  is when people have high resting heart rates that increase inappropriately fast to minimal exertion.  A typical person has an average heart rate for the day of 110 beats per minute that increase to 150-160 with walking or climbing stairs.

IST is one strong possibility and is very difficult to treat.  Once reversible causes are ruled out like thyroid or adrenal problems, it is probably worth seeing a pediatric electrophysiologist to see what they think.

I hope this helps and good luck.