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Opinions.. Why do you think palpitations are so scary to patients?
Ive noticed alot, and even the own forum doctors have mentioned, how patients presenting with benign palpitations are so afraid they are dying, and yet the seriously ill patients with prior MI's or are at very high risk, dont worry about this at all.. Does any one have any personal insight or opinion as to why this may be? Its always made me wonder..
Lots of it is because they do not trust their doctors/cardiologists. On the back of their mind there is always the "what if" they (doctors/cardiologists)might have missed something, they made a mistake etc. They go on message boards and believe when somebody says "your next exercise might be your last" as I was told on this very board 3 yrs ago when I mentioned my PVC's during exercise. I, myself only believe what a Cardiologist tells me, but not everybody is like me, some people take these posts/messages veyu seriously. Some people cannot afford health insurance, and come on message boards because they are scared and are looking for answers instead of going to a free Clinic or ER at a Teaching Hospital where they get billed accordingly or not billed at all.
Why do people who had an MI or a serious heart problem are less scared? Because most of them if not all of them have received and are receiving treatment. There is no "what if", they know they had a heart attack, the Cardiologists told them exactly what is going on and what the future has got in store for them i.e. with heart failure for example, the Cardiologists lay it on the line that after a heart attack you need to do certain exercises and in most people life style changes if you want to live long enough to see your kids/grandkids graduate.
There are still people after a heart attack who are also scared, not trusting 100% what their Cardiologists tell them afraid of another heart attack at any time even though the Cardiologist tell them there is a slim chance. I know of one case where the person quit his job out of fear he'd have another heart attack at work, he is at home afraid to go anywhere, his wife goes to work to support them.
Last but not least Professionals in the Medical field need to understand about anxiety. Just because they never experienced PVC's or extreme anxiety it doesn't help the patient when a Medical Professional says stuff like "exactly what are you afraid of?" I never heard of that. "So your heart skips, just let it skip". Therapists/Psychologists to quickly to prescribe pills instead of really talking to the patient for the one hour you pay them for, and not sitting there totally quiet while you spill your guts out, all along you know they are thinking of something else. It should not take a book to help a patient as it did for me.
Unless the Medical Professionals take people with a "heart phobia" seriously instead of asking themselves "we don't understand why people with benign PVC's are so afraid while people with serious heart attacks are not" This of course is not true. I know people who are so afraid of another heart attack they became invalids. One of them even managed to get disability out of fear any job would damage his heart. The docs didn't want to agree for the disability at first but after many months he got his way.
And maybe if doctors would not hurry out patients out of the door after 5 minutes when the Insurance pays them for 45 minutes, maybe some patients would have more trust in their doctors.
And maybe if they would experience these PVC's for themselves, especially when every other beat skips for weeks, maybe then they would understand better and not ask stupid questions.
Why do people who had an MI or a serious heart problem are less scared? Because most of them if not all of them have received and are receiving treatment. There is no "what if", they know they had a heart attack, the Cardiologists told them exactly what is going on and what the future has got in store for them i.e. with heart failure for example, the Cardiologists lay it on the line that after a heart attack you need to do certain exercises and in most people life style changes if you want to live long enough to see your kids/grandkids graduate.
There are still people after a heart attack who are also scared, not trusting 100% what their Cardiologists tell them afraid of another heart attack at any time even though the Cardiologist tell them there is a slim chance. I know of one case where the person quit his job out of fear he'd have another heart attack at work, he is at home afraid to go anywhere, his wife goes to work to support them.
Last but not least Professionals in the Medical field need to understand about anxiety. Just because they never experienced PVC's or extreme anxiety it doesn't help the patient when a Medical Professional says stuff like "exactly what are you afraid of?" I never heard of that. "So your heart skips, just let it skip". Therapists/Psychologists to quickly to prescribe pills instead of really talking to the patient for the one hour you pay them for, and not sitting there totally quiet while you spill your guts out, all along you know they are thinking of something else. It should not take a book to help a patient as it did for me.
Unless the Medical Professionals take people with a "heart phobia" seriously instead of asking themselves "we don't understand why people with benign PVC's are so afraid while people with serious heart attacks are not" This of course is not true. I know people who are so afraid of another heart attack they became invalids. One of them even managed to get disability out of fear any job would damage his heart. The docs didn't want to agree for the disability at first but after many months he got his way.
And maybe if doctors would not hurry out patients out of the door after 5 minutes when the Insurance pays them for 45 minutes, maybe some patients would have more trust in their doctors.
And maybe if they would experience these PVC's for themselves, especially when every other beat skips for weeks, maybe then they would understand better and not ask stupid questions.
My father was a young person with diagnosed CAD and he simply would not comply with doctor's warnings about being cautious. His primary food source was the 7-11. Funnily enough, this is a common characteristic of people who are actually sick. It is understandable because emotionally healthy people don't want to be disabled and don't like living as if they are.
Often with emotional/anxiety issues the person is all too willing to give up on life, retire to bed, avoid exercise, stay cloistered in the house for fear of dying in public etc.
My guess is that it is quite normal to, initially, respond to heart palpitations with some concern, even for the concern to persist for a little while and to go through "stages" before realizing that everyone gets these beats, most healthy hearts just do that,one is still here and clearly the palps are not serious.
That said, some people are prone to fear, depression or obsessive thoughts. I also believe that many people have certain stressors that they do not wish to acknowledge as such. Burying complicated feelings may also have something to do with it. I will wager there are many personality traits in common, many of them (like sensitivity) quite good traits in the right context.
Now, clearly, the brain monitors everything, so it can easily be implicated in all sorts of problems people experience, not to mention genetics, but sometimes people would rather be ill than stressed. This way they are "proven" "right". Like that old joking tombstone inscription: "See? I Told You I Was Sick".
If one has a battery of healthy tests and still insists, it could be that one is "right" (generally about having a non-life threatening condition), but the probability is clearly on the side of anxiety/stress reaction.
This kind of fear cycle is hard to break, and my suspicion is that being on the Internet does not help at all, regardless of what people think. My guess is that the cycle itself needs to be broken. Doctors are even trying Auditory Therapy to break it (interrupting obsessive thoughts).
Often with emotional/anxiety issues the person is all too willing to give up on life, retire to bed, avoid exercise, stay cloistered in the house for fear of dying in public etc.
My guess is that it is quite normal to, initially, respond to heart palpitations with some concern, even for the concern to persist for a little while and to go through "stages" before realizing that everyone gets these beats, most healthy hearts just do that,one is still here and clearly the palps are not serious.
That said, some people are prone to fear, depression or obsessive thoughts. I also believe that many people have certain stressors that they do not wish to acknowledge as such. Burying complicated feelings may also have something to do with it. I will wager there are many personality traits in common, many of them (like sensitivity) quite good traits in the right context.
Now, clearly, the brain monitors everything, so it can easily be implicated in all sorts of problems people experience, not to mention genetics, but sometimes people would rather be ill than stressed. This way they are "proven" "right". Like that old joking tombstone inscription: "See? I Told You I Was Sick".
If one has a battery of healthy tests and still insists, it could be that one is "right" (generally about having a non-life threatening condition), but the probability is clearly on the side of anxiety/stress reaction.
This kind of fear cycle is hard to break, and my suspicion is that being on the Internet does not help at all, regardless of what people think. My guess is that the cycle itself needs to be broken. Doctors are even trying Auditory Therapy to break it (interrupting obsessive thoughts).
WOW!! Interesting question!!
Along those same lines, why do so many smokers worry about palps when they should be worried about the cigarettes? The doctor looks you in the eye tells you the palps are benign, but that smoking is dangerous to your health...you continue to smoke and worry about the palps. Hmmmmm
I know others who deal with serious heart disease and other health problems. They don't seem to dwell on the bothersome effects of their afflictions (ie, nausea, palps, SOB, etc). Instead, they accept the diagnosis, follow the suggestions of their doctors, and live their lives as best they can. I think when you are afflicted with a serious illness, you learn to value the smaller things in life, and opt not to dwell on the things that may be beyond your control or those which you have been assured are not relevant to your well-being. You've gotter bigger fish to fry...
On the other hand, in healthy folks, pvcs present us with a physical reminder (the thumps, bumps, flips) that we might not be "normal." Once the doctor assures us that we are fine, we find it "necessary" to dwell on the what if's. However, had we actually been diagnosed with a serious illness, the palps would become less significant. Imagine you are told you will need a biopsy or a scan b/c they "found something." Suddenly, your benign palps are not so important. When we have nothing else to worry about, maybe we focus on what we "notice."
I've come to accept that there are some things in life I can control, and others I cannot not. I've found doctors that I trust and are willing to offer assurance coupled with a thorough diagnostic workup when it is necessary.
I don't even know if that answers the question, but I tried : )
Hope you are doing great!
Along those same lines, why do so many smokers worry about palps when they should be worried about the cigarettes? The doctor looks you in the eye tells you the palps are benign, but that smoking is dangerous to your health...you continue to smoke and worry about the palps. Hmmmmm
I know others who deal with serious heart disease and other health problems. They don't seem to dwell on the bothersome effects of their afflictions (ie, nausea, palps, SOB, etc). Instead, they accept the diagnosis, follow the suggestions of their doctors, and live their lives as best they can. I think when you are afflicted with a serious illness, you learn to value the smaller things in life, and opt not to dwell on the things that may be beyond your control or those which you have been assured are not relevant to your well-being. You've gotter bigger fish to fry...
On the other hand, in healthy folks, pvcs present us with a physical reminder (the thumps, bumps, flips) that we might not be "normal." Once the doctor assures us that we are fine, we find it "necessary" to dwell on the what if's. However, had we actually been diagnosed with a serious illness, the palps would become less significant. Imagine you are told you will need a biopsy or a scan b/c they "found something." Suddenly, your benign palps are not so important. When we have nothing else to worry about, maybe we focus on what we "notice."
I've come to accept that there are some things in life I can control, and others I cannot not. I've found doctors that I trust and are willing to offer assurance coupled with a thorough diagnostic workup when it is necessary.
I don't even know if that answers the question, but I tried : )
Hope you are doing great!
I agree with you totally - and you too Kit.
It's the FEAR.
When you are actually dx with a condition you know what you have to do. In the case that Collegegirl has requested. For a patient who has had MI they are treated accordingly, told what lifestyle changes they have to make - given the meds, have follow up appointments, checked on regularly by the medical field who know what they are dealing with and know how to deal with it. Same for me when dx with MS I know my limitations, I know to expect etc., and I am dealt by sympathetic neuros who know how do address my relapses as and when they occur.
When I see the cardios about PVC's and they say that they are benign and to get on with my life and that they are all in my head I feel that in their minds they are thinking "oh here we go another one". It is something that they don't have any answers to. When questions are put to them like "why do I get thousands a day and sometimes none? Why do I get more lying down?" they just look blank and say "well it's all in your head"
So I think the reason that so many people find them scary is that the heart specialist can find no reason for them, and so they just dismiss them and us in the process (leaving us to feel that we are going totally around the bend) still trying to find that one tiny little reason that we are having them, never for once believing that to be having thousands of PVC's a day is a normal event, but to the cardios they are!!!
I also agree that the Internet is great source of misinformation too - and that some of these other websites can scare the living daylights out of you.
It's the FEAR.
When you are actually dx with a condition you know what you have to do. In the case that Collegegirl has requested. For a patient who has had MI they are treated accordingly, told what lifestyle changes they have to make - given the meds, have follow up appointments, checked on regularly by the medical field who know what they are dealing with and know how to deal with it. Same for me when dx with MS I know my limitations, I know to expect etc., and I am dealt by sympathetic neuros who know how do address my relapses as and when they occur.
When I see the cardios about PVC's and they say that they are benign and to get on with my life and that they are all in my head I feel that in their minds they are thinking "oh here we go another one". It is something that they don't have any answers to. When questions are put to them like "why do I get thousands a day and sometimes none? Why do I get more lying down?" they just look blank and say "well it's all in your head"
So I think the reason that so many people find them scary is that the heart specialist can find no reason for them, and so they just dismiss them and us in the process (leaving us to feel that we are going totally around the bend) still trying to find that one tiny little reason that we are having them, never for once believing that to be having thousands of PVC's a day is a normal event, but to the cardios they are!!!
I also agree that the Internet is great source of misinformation too - and that some of these other websites can scare the living daylights out of you.
Unless a doctor/nurse or any of their relatives are having severe PVC's they do NOT understand.
Let me give you an example. I've severe white coat hypertension for the last 30 yrs. I have a phobia. I tried to get help over the yrs. Anti anxiety, anti depressants even beta blockers did not help. When at a doctors's appointment and when having my BP/Beta Blockers etc. Without meds it went to 255/160 one time. At home it was 115/75 most of the time. If the tranqualizers/anti deopressant were increased I could not function, wanted to sleep all day, but my anxiety was still there, not as severe, but the BP still shut up over 170. I took this anti anxiety/anti depressent medicine route for 2 yrs, to no avail.
I seeked professional help. This is what I came across and got from professionals as in doctors/nurses: "What exactly are you afraid of?? that the cuff wont deflate??,( I felt totally humiliated) or "all you need to do is take a deep breath" jeah right, believe me I even was in deep breathing exercises/therapy and biofeedback. 20 yrs ago, when I was still younger a male nurse said to me "I bet your BP rises so high when you see a good looking man like me" of course he was joking but it didn't help me any. Or medical staff after taking my BP were raising their voices "oh my god, look at that BP YOU HAVE TO CALM DOWN", scolding me like I did that on purpose. Every time before taking my BP I said "don't tell me, the numbers will be high, let the doctor tell me", but every time I got the same reaction, "oh my god" of course the anxiety got even worst, and I ended up rushed to the ER one time when my BP was 255/160 after they scared the hell out of me on top of my already high BP due to anxiety.
I seeked Therapists about this phobia. One of them made me yell at a chair pretending the chair was my BP, I even went to a Psychiatrist, get ready for this: I was in and out in 3 minutes max, he said "stay away from hospitals and doctors", and walked out. I turned him in with letters and brought it to the attention how unprofessional he was and also told my Insurance company and prepared them for the "3 minute bill" which I'm sure he did not mention that he saw me only for 3 minutes. How can anybody even a young person stay away from doctors and hospitals??????? I was 35 yrs old at the time.
Fast forward to 2005. I saw a Cardiologist and told him about my white coat hypertension after it was 220/127 when his Technician took it. The Cardioilogist told me "OH I KNOW EXACTLY WHAT YOU ARE GOING THROUGH MY WIFE HAS THE SAME PHOBIA. FROM NOW ON TAKE YOUR BP AT HOME AND BRING IN YOUR READINGS TO "EVERY" DOCTOR YOU GO TO". You see, it took a Cardilogist whose WIFE was in the SAME boat as me to "UNDERSTAND".
He put me on BP meds, even though I think it was all anxiety/phobia, but I do take the BP meds but he also told me that if a severe panic attack all the BP meds will not help at that moment for people who react very hypertensive during a panic attack.
I get these attacks 95% under control, thanks to books by some Australian Psychiatrist who was interested in people like us and was interested to really help us.
Let me give you an example. I've severe white coat hypertension for the last 30 yrs. I have a phobia. I tried to get help over the yrs. Anti anxiety, anti depressants even beta blockers did not help. When at a doctors's appointment and when having my BP/Beta Blockers etc. Without meds it went to 255/160 one time. At home it was 115/75 most of the time. If the tranqualizers/anti deopressant were increased I could not function, wanted to sleep all day, but my anxiety was still there, not as severe, but the BP still shut up over 170. I took this anti anxiety/anti depressent medicine route for 2 yrs, to no avail.
I seeked professional help. This is what I came across and got from professionals as in doctors/nurses: "What exactly are you afraid of?? that the cuff wont deflate??,( I felt totally humiliated) or "all you need to do is take a deep breath" jeah right, believe me I even was in deep breathing exercises/therapy and biofeedback. 20 yrs ago, when I was still younger a male nurse said to me "I bet your BP rises so high when you see a good looking man like me" of course he was joking but it didn't help me any. Or medical staff after taking my BP were raising their voices "oh my god, look at that BP YOU HAVE TO CALM DOWN", scolding me like I did that on purpose. Every time before taking my BP I said "don't tell me, the numbers will be high, let the doctor tell me", but every time I got the same reaction, "oh my god" of course the anxiety got even worst, and I ended up rushed to the ER one time when my BP was 255/160 after they scared the hell out of me on top of my already high BP due to anxiety.
I seeked Therapists about this phobia. One of them made me yell at a chair pretending the chair was my BP, I even went to a Psychiatrist, get ready for this: I was in and out in 3 minutes max, he said "stay away from hospitals and doctors", and walked out. I turned him in with letters and brought it to the attention how unprofessional he was and also told my Insurance company and prepared them for the "3 minute bill" which I'm sure he did not mention that he saw me only for 3 minutes. How can anybody even a young person stay away from doctors and hospitals??????? I was 35 yrs old at the time.
Fast forward to 2005. I saw a Cardiologist and told him about my white coat hypertension after it was 220/127 when his Technician took it. The Cardioilogist told me "OH I KNOW EXACTLY WHAT YOU ARE GOING THROUGH MY WIFE HAS THE SAME PHOBIA. FROM NOW ON TAKE YOUR BP AT HOME AND BRING IN YOUR READINGS TO "EVERY" DOCTOR YOU GO TO". You see, it took a Cardilogist whose WIFE was in the SAME boat as me to "UNDERSTAND".
He put me on BP meds, even though I think it was all anxiety/phobia, but I do take the BP meds but he also told me that if a severe panic attack all the BP meds will not help at that moment for people who react very hypertensive during a panic attack.
I get these attacks 95% under control, thanks to books by some Australian Psychiatrist who was interested in people like us and was interested to really help us.
I always had normal BP readings until I went to the doctor and had some (thankfully benign) tissue removed from my mouth. The anesthetic partially failed and I was in terrible pain during the procedure, my blood pressure shot up and after that, my trips to the doc had higher readings. In one docs office the nice nurse would take it, get a normal (120/80) reading and the doctor would barge in say "Let ME do it" and, sure enough, get a (low range 140/90 ish) "high" one. After that I got 140/90 ish in all docs offices for a little while.
When she tried to medicate me, I ignored her and now, just months later, when I go in to the doctor's office my BP is always normal and everyone seems to have forgotten "the crisis" LOL
Side note: When the BP thing was going on I asked for a 24-hr monitor before I would accept meds. She said she could borrow one from the pharmaceutical company. When I went in for it on the day appointed, they said the pharmaceutical company had stopped providing the amublatory BP monitor. I immediately realized it was no longer provided because the 24-hr readings were probably showing a great deal of white coat HTN and that meant they were losing Rx's for their products :-/
Sherma: The reaction of my BP in that one doctor's office does illustrate your point about the effect of fear on the body. She intimidated me enough to temporarily raise it. Fear and stress over palps could easily cause more palps and make them feel worse.
When she tried to medicate me, I ignored her and now, just months later, when I go in to the doctor's office my BP is always normal and everyone seems to have forgotten "the crisis" LOL
Side note: When the BP thing was going on I asked for a 24-hr monitor before I would accept meds. She said she could borrow one from the pharmaceutical company. When I went in for it on the day appointed, they said the pharmaceutical company had stopped providing the amublatory BP monitor. I immediately realized it was no longer provided because the 24-hr readings were probably showing a great deal of white coat HTN and that meant they were losing Rx's for their products :-/
Sherma: The reaction of my BP in that one doctor's office does illustrate your point about the effect of fear on the body. She intimidated me enough to temporarily raise it. Fear and stress over palps could easily cause more palps and make them feel worse.
Momto3 and the rest of you make great points! Im thinking of doing a research paper on this topic as it fascinates me! Why would a smoker, whos told smoking is so dangerous for you, or anyone with a particular lfestyle or other health risk (such as anxiety, which will probably hurt you more than palps) , be content to suffer the consequnces of those and still focus on the benign palps... Ide LOVE to be involved in a study on this..An actual physical study of people who have health related anxiety due to palps.. Ide love to see their body's physical reaction to the palp, whats going on inside,.. Inside the brain, the adrenals, everything.. There the med geek in me came out!
Thank you everyone!
Thank you everyone!
Could it be because cigarettes are an addiction? People know what cigarettes can cause yet they can't stop just like drug users, and unless they get help can't quit. I know some of them can quit cold turkey but many can't.
My husband tried for many years and always start smoking again. He smoked 4 packs for 45 yrs. Four yrs ago he had a lung cancer scare and the Lung Specialist told him if he doesn't quit smoking it will turn into lung cancer. He had a benigh nodule on his lung. Even with that lung cancer scare it took one year of pills (Welbutrin) for him to stop smoking, and he tells me several times a week he dreams about wanting a cigarette, smoking a cigarette, two nights ago he dreamed that he bought 4 cartons of Marlboro, and this after over 3 yrs since he quit smoking.
I guess if you have a severe addiction you can't quit, no matter how many warnings, people keep on smoking and worry more about palps unless they get help to kick the smoking habit. Its a very rough road. I never smoked but I witnessed my husband what he went through, the urges, the shaking of his hands because he wanted a cigarette so bad. Nicotine gum did not take the urge away only the Welbutrin but not 100% he still got the shakes. And working with co-workers who all smoke does not help either.
My husband tried for many years and always start smoking again. He smoked 4 packs for 45 yrs. Four yrs ago he had a lung cancer scare and the Lung Specialist told him if he doesn't quit smoking it will turn into lung cancer. He had a benigh nodule on his lung. Even with that lung cancer scare it took one year of pills (Welbutrin) for him to stop smoking, and he tells me several times a week he dreams about wanting a cigarette, smoking a cigarette, two nights ago he dreamed that he bought 4 cartons of Marlboro, and this after over 3 yrs since he quit smoking.
I guess if you have a severe addiction you can't quit, no matter how many warnings, people keep on smoking and worry more about palps unless they get help to kick the smoking habit. Its a very rough road. I never smoked but I witnessed my husband what he went through, the urges, the shaking of his hands because he wanted a cigarette so bad. Nicotine gum did not take the urge away only the Welbutrin but not 100% he still got the shakes. And working with co-workers who all smoke does not help either.
I thought about that, the addiction part. I would agree that it is probably the reason people ignore the warnings. But, some of theose same people are TERRIFIED of palps despite the doctor's reassurance. I can't figure out why. If you REALLY thought something was wrong with your heart to the point of chasing down doctors for risky treatments, why would you continue to smoke? Of course, there's where the addiction cycle kicks back in....definitely a tough one.
My dad had a similar experience to your husband...only his was a heart scare. At 48, he was in the ER with chest pains. The doctor asked him if he smoked. My dad said, "Yes, I do." And the doctor said, "You did." He had always told us he would quit if the doctor told him to. I guess he wasn't going to do it on his own though. The ER doctor's words (and the chest pain) were enough for him - he was one of the lucky one who was able to quit even after smoking for about 25 years. Like your husband, my dad still craves a cigarette now and again, but he says he's not sure he wouldn't start up the habit again. So he refrains. I'm so glad to hear that your husband was able to kick the habit. Kudos to him! I can't even imagine how difficult that must have been.
What's interesting is that since my dad's bypass about 9 years ago, he worries a LOT less about aches and pains, palps, SOB, etc. He does as the doctor tells him and lives his life. Before the surgery, he worried about a lot more!
As for doctor's having a better understanding when they can relate to the problem, I agree. I think that's probably true for all of us...I know it helped raising 3 teenagers...I could look back and remember how things were when I was growing up and it helped explain why they did the things they did...hahahaha
Collegegirl -- You're onto something here! GREAT research project idea!! You're gonna do just fine with medicine :)
Have a great day everyone!
My dad had a similar experience to your husband...only his was a heart scare. At 48, he was in the ER with chest pains. The doctor asked him if he smoked. My dad said, "Yes, I do." And the doctor said, "You did." He had always told us he would quit if the doctor told him to. I guess he wasn't going to do it on his own though. The ER doctor's words (and the chest pain) were enough for him - he was one of the lucky one who was able to quit even after smoking for about 25 years. Like your husband, my dad still craves a cigarette now and again, but he says he's not sure he wouldn't start up the habit again. So he refrains. I'm so glad to hear that your husband was able to kick the habit. Kudos to him! I can't even imagine how difficult that must have been.
What's interesting is that since my dad's bypass about 9 years ago, he worries a LOT less about aches and pains, palps, SOB, etc. He does as the doctor tells him and lives his life. Before the surgery, he worried about a lot more!
As for doctor's having a better understanding when they can relate to the problem, I agree. I think that's probably true for all of us...I know it helped raising 3 teenagers...I could look back and remember how things were when I was growing up and it helped explain why they did the things they did...hahahaha
Collegegirl -- You're onto something here! GREAT research project idea!! You're gonna do just fine with medicine :)
Have a great day everyone!
As you know, my son has over a thousand PVC/PACs a day, anyone listening can detect them, and he doesn't notice. His heart is not structurally "normal" (exactly) but he isn't on meds, is fully informed and doesn't worry about them.
The FACT of them isn't the problem for people, it's the sensitivity to the sensation.
The cardiologist is out of the picture (or in an ideal world ought to be) once there is nothing determined to be wrong with the heart. They cannot explain exactly why people behave differently in response to their bodily sensations, no.
If people read up on the biology of stress they might discover some things they find interesting and useful.
We also don't address the people who have these screening heart exams, pass them with flying colors, and do NOT become obsessed with their hearts. Reading the boards is highlighting a subset of patients who are particularly disturbed by them. What do the people able to accept have in common ?
Often, the doctors try to give stressed patients something that may diminish their symptoms, rather than tell them they have anxiety, because many patients cannot adapt to the sensations and insist it's caused by some disease. Since everybody gets some ectopics, the causes are either numerous or common and, except in rare instances, ultimately not indicative of a disease. It seems the more honest the physician is with the patient about the topic, the worse response they sometimes get.
At some point, the continued pursuit of a medical problem may involve injured pride and dignity as well.
Making light of it, as some doctors do, (however tempting it may be) may work with some people but offend others. The internalized anger after taking offense may only make the person more likely to continue to concentrate on the topic, to seek validation.
Emotional needs are very powerful and legitimate too.
This is an interesting question, and I think alot of people have hit on some very good reasons.
I think it is important to look at people, even if they smoke or have depression or anxiety problems with heart conditions, as heart patients. They shouldn't be looked down upon, or treated poorly because they smoke--most likely they want to quit, given that nicotine is next to heroin in terms of addiction.
Heart patients might not pay as much attention to skips, but it is something in the back of their minds. The real question lies in that doctors don't even know what causes these nasty skips, so it begs the question as how can they dismiss them so quickly....there lies a major issue.
PVCs and other arrythymias in people with structurally abnormal hearts including coronary artery disease do have risk.
People that have skips that have had family members drop dead on them from sudden heart attacks question this even moreso.
Cardiologists want to treat the easy cases--obvious blockages, defects, etc. These are the garden variety cases. It takes a cardiologist with interest and dedication to talk with the patient and walk through their symptoms, rather than a terse, "you're not going to die" reply.
Patients will further have questions and anxiety once they are told, not to worry and they keep having symptoms--this will keep rolling like a snowball until a person comes to grip, gets better/worse.
I think it is important to look at people, even if they smoke or have depression or anxiety problems with heart conditions, as heart patients. They shouldn't be looked down upon, or treated poorly because they smoke--most likely they want to quit, given that nicotine is next to heroin in terms of addiction.
Heart patients might not pay as much attention to skips, but it is something in the back of their minds. The real question lies in that doctors don't even know what causes these nasty skips, so it begs the question as how can they dismiss them so quickly....there lies a major issue.
PVCs and other arrythymias in people with structurally abnormal hearts including coronary artery disease do have risk.
People that have skips that have had family members drop dead on them from sudden heart attacks question this even moreso.
Cardiologists want to treat the easy cases--obvious blockages, defects, etc. These are the garden variety cases. It takes a cardiologist with interest and dedication to talk with the patient and walk through their symptoms, rather than a terse, "you're not going to die" reply.
Patients will further have questions and anxiety once they are told, not to worry and they keep having symptoms--this will keep rolling like a snowball until a person comes to grip, gets better/worse.
I completely agree that despite any internal, external,environmental or other factors, each patient should be considered as a whole person in need of answers.
I have a doctor who says that each time a new patient arrives in her office, she considers him/her as a special package (gift) to open. You can begin by reading the card (chart), untying the ribbons (listening to the patient's symptoms, and learning as much as you can about the contents. She said that it makes every patient special! What a great way to meet a new doctor -- as if you were a gift, something very, very special!
I have a doctor who says that each time a new patient arrives in her office, she considers him/her as a special package (gift) to open. You can begin by reading the card (chart), untying the ribbons (listening to the patient's symptoms, and learning as much as you can about the contents. She said that it makes every patient special! What a great way to meet a new doctor -- as if you were a gift, something very, very special!
Because of the way I was treated either no understanding at all, or scaring the hell out of me as I stated in my post above, or humiliated (see post above) or making fun of, or just brushed off with a 3 minute visit because of that I stopped going to doctors for 8 yrs. I could not take it anymore, not understanding my phobia, I came to the point that I was willing to play Russian Roulette with my body/health that is how bad it became.
I stopped it all. No more visits not even to the Gynecologist, ALL doctors, everywhere where there was a BP measurement involved I did not go. Only to the eye doctor, I thought no BP measurement, so I thought. At one particular eye exam the eye doctor found a small bleeding blood vessel in the back of my eye, and went and got the blood pressure cuff, and I got so high anxiety that my BP shut over 200 again. I could not leave the office until the BP was 170 syst. which was still way to high, but I told her that it wont go down until I leave her office. She urged me to see a Cardiologist, she too never heard of my phobia. BTW, the bleeding blood vessel was from high blood pressure.
I made an appointment with a Cardiologist and the rest is history as I stated above what he said/did and "why" he understood.
But because of this no understanding and unprofessional behavior, scaring me instead of trying to take the fear out of me I gambled with my health for 8 yrs by not seing any doctor.
I stopped it all. No more visits not even to the Gynecologist, ALL doctors, everywhere where there was a BP measurement involved I did not go. Only to the eye doctor, I thought no BP measurement, so I thought. At one particular eye exam the eye doctor found a small bleeding blood vessel in the back of my eye, and went and got the blood pressure cuff, and I got so high anxiety that my BP shut over 200 again. I could not leave the office until the BP was 170 syst. which was still way to high, but I told her that it wont go down until I leave her office. She urged me to see a Cardiologist, she too never heard of my phobia. BTW, the bleeding blood vessel was from high blood pressure.
I made an appointment with a Cardiologist and the rest is history as I stated above what he said/did and "why" he understood.
But because of this no understanding and unprofessional behavior, scaring me instead of trying to take the fear out of me I gambled with my health for 8 yrs by not seing any doctor.
Sometimes it can be the "life context" of the patient. In my situation, I was diagnosed with familial hypercholesterolemia when I was very young (5 years old). I was diagnosed after my Dad had a heart attack at 45 yrs old - I inherited it from him. Unfortunately, my Dad did not take very good care of himself - he wouldn't take his medicine, wouldn't go to doctors, continued to smoke and eat whatever he wanted. I lived in constant fear that I would lose him as did my Mom and sisters. When he was 60, he had to have quadruple bypass surgery as well as carotid bypass surgery (he passed out at the dinner table) - it was a very scary time for all of us. I was the closest to him so I was his caretaker during all of this. Unfortunately, all of this took a toll on me and I started to worry that this was what in store for me in the future. He came through the bypass surgery but began to smoke again as soon as he could take a deep breath. We again lived in fear of losing him to heart disease and I felt helpless. 8 years later at the age of 68 he developed endocarditis (infection on his heart) following a dental procedure. He didn't tell me he was sick until he was very sick. We took him to the emergency room and they transported him to Boston immediately. Because the endocarditis was so advanced, they had to do valve replacement surgery on him. Unfortunately, he was over anti-coagulated and had a massive cerebral hemmorhage during the surgery. He survived but was paralyzed on his right side as a result. This was devestating to him and to all who loved him. It was very difficult to watch. He never really recovered from this and died about 9 months later from a heart attack. During this final period in his life, I was his constant caretaker. I continued to worry that things like this were in my future although I have lived my life very differently than my Dad. The trauma of losing him the way that I did has stayed with me. I loved him more than anything in the world. Fast forward 7 years - following a very stressful time at work, I developed PVCs. I have had them for 4 years and I have learned to accept them. But for me, the feeling of a PVC was particularly scary because for some reason, it brought back memories of my Dad and all of his struggles. It was a reminder of how devestating heart disease can be and a reminder that I carry a higher risk even though I clearly understand that my PVCs are benign. When my heart skips around, I seem to relive some of the bad times - I wish I didn't but I do. I guess anything heart related is difficult for me. So I wonder if some of the people that are very afraid of palpitations are afraid because they trigger a memory.
YES, YES, YES to your very last question. I was hospitalized for one solid year at the age of 3 because of severe TB that almost killed me, that was before TB meds. I did not know and understand why I could not go home to be with my family. Ever since then I developed a phobia of doctors and hospital. My mom told me that when I was little and she had to take me to the doctor the first thing I said was "will this doctor send me to the hospital again"? My mom said "no" but even at a very young age like 4, 5, and 6 I already said to my mom "but what if they will find that I am sick, I then will have to go to the hospital again for a long time".
You see, the "what if" and "what will they find" stayed in my head all through my life.
Then there was my grandma. She was born in 1986, and when she started to have high BP later on that was still before BP meds, home monitors, holters etc, she never even got an EKG that I remember. Her blood pressure at times got so high, she got short of breath, her face beet red, the whole nine yards. I remember seing her walking around with her hand on the left side of her chest saying "I wish these heart pains would go away" All the doctor ever gave her were some "drops", herbal stuff or whatever. I was 10 yrs old at the time and took care of her because my mom worked full time, my Dad took a hike when I was 6, they divorced. I took care of my grandma when she was sick. She used to say "hurry, hurry get my drops, my heart is beating out of my chest". My own heart started to pound like a maniac out of fear she'd die.
When I walked home from school my heart was pounding whether I would find my grandma dead.
That and the one year in the hospital causes/caused my phobia. I found this out on my own, no Therapist or shrink agreed with me that these are the reasons, but I know better.
BTW, my grandma despite her severe high BP at times and heart problems died in her sleep at the age of 83 from cancer. She had these BP and heart problems for 30 yrs.
You see, the "what if" and "what will they find" stayed in my head all through my life.
Then there was my grandma. She was born in 1986, and when she started to have high BP later on that was still before BP meds, home monitors, holters etc, she never even got an EKG that I remember. Her blood pressure at times got so high, she got short of breath, her face beet red, the whole nine yards. I remember seing her walking around with her hand on the left side of her chest saying "I wish these heart pains would go away" All the doctor ever gave her were some "drops", herbal stuff or whatever. I was 10 yrs old at the time and took care of her because my mom worked full time, my Dad took a hike when I was 6, they divorced. I took care of my grandma when she was sick. She used to say "hurry, hurry get my drops, my heart is beating out of my chest". My own heart started to pound like a maniac out of fear she'd die.
When I walked home from school my heart was pounding whether I would find my grandma dead.
That and the one year in the hospital causes/caused my phobia. I found this out on my own, no Therapist or shrink agreed with me that these are the reasons, but I know better.
BTW, my grandma despite her severe high BP at times and heart problems died in her sleep at the age of 83 from cancer. She had these BP and heart problems for 30 yrs.
I can really relate to what you have gone through. Once they found out that I had FH, I had to go to Boston Children's hospital every month to have my blood drawn and other tests done. Childhood is such an impressionable time and those things stay with us. The fear of losing someone you love is very powerful. I think it's very difficult to unlearn fears that were set in place at a young age.
This is very interesting to me.. I really want to see what part of the brain is active immediatly following the palpitation.. I think figuring out exactly what physical reaction is happening and WHY its happening (whether it be triggered memory, predisposition to anxiety or depression) could greatly help patients suffering from obsessive thoughts and anxiety due to the palps.. Imagine if medicine could identify exactly the reactions happening in the brain that are causing patients to obsess on this one thing, how many people could be treated through medication or CBT and be spared so much grief.. Palps would only be the start!
Thanks for everyones input! Ide love to see more if anyone has anything else to add
Thanks for everyones input! Ide love to see more if anyone has anything else to add
I think your idea for a study would be great. I am a sufferer of health anxiety and have PACs and PVCs. I guess what scares me most is the thought I will go into atrial fib. The idea of atrial fib seems horrible to me because it could go on and on for long periods and be incapacitating. I realize I probably won't drop dead from these things, though I thought I would for a long time. Now, it's just the idea that they will be incapacitating. I worry I will develop bigeminy, a-fib or even just frequent palps and my fear will get so bad and I may even be physically incapacitated, unable to work, to be with my family, to have a life. To think I'll be an invalid and just have to sit in the house and/or go to doctors and hospitals all the time (I hate going to doctors). That is just a look into the thoughts going through my head when the palps start. Hope it's enlightening in some way!
Ugh i know! Ive been there!! And being there didnt help me figure it out either! Just being on the otherside of that horrible part of my life made me realize how much needs to be done to help people suffering from these things mentally as well as physically :)
In my case the fear fell into two categories.
First, my PVCs caused severe pain. Pain is an unpleasant stimulus and thus a fear of the trigger of that pain is a natural reaction.
Secondly, my aforementioned belief that PVCs are a marker of more serious heart troubles causes a desire to avoid such consequences.
First, my PVCs caused severe pain. Pain is an unpleasant stimulus and thus a fear of the trigger of that pain is a natural reaction.
Secondly, my aforementioned belief that PVCs are a marker of more serious heart troubles causes a desire to avoid such consequences.
Thats another interesting perspective.. I know alot of patients complain of some kind of chest discomfort with palpitations, whether it be mild or severe.. I wonder if these feelings of pain from the palpitations repeaditly is enough to induce some kind of secondary mental trauma, then at the same time that leaves the door open to the idea that just the fluttering feeling in itself may be traumatic..
We are told from a very young age our heart is our most important organ..It doesnt suprise me at all palpitation patients are concerned about their hearts..What concerns me is where the intensity is coming from in some of the patients.. In my own personal experience with palpitations, i know that fear for me was blind and i couldnt rationalize it, but i was still irrationally scared to death.. I want to know where that comes from. I think it could help many people.
We are told from a very young age our heart is our most important organ..It doesnt suprise me at all palpitation patients are concerned about their hearts..What concerns me is where the intensity is coming from in some of the patients.. In my own personal experience with palpitations, i know that fear for me was blind and i couldnt rationalize it, but i was still irrationally scared to death.. I want to know where that comes from. I think it could help many people.
For me, the intensity of the fear was proportional to the intensity of the pain, modified somewhat by the frequency of the pain and the latency from the last pain stimulus.
I think it is a classic pain adaptive behavior.
I think it is a classic pain adaptive behavior.
I know...it does seem like so many people are absolutely TERRIFIED of their palpitations. I know, because I am one of them! Maybe we are "hard-wired" somehow to be attuned to problems with our hearts, because it is such an important and vital organ. I also have severe headaches, and when I get one, I don't go into panic mode and start thinking it's a brain tumor, an aneurysm, etc. But when I get a palp, it automatically sends me into terror. That is very odd...it seems to be quite unique to the experience of palps and is very interesting.
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