Aa
Scared
I am a 62 year old woman. I have had heart palps virtually as long as I can remember and finally reached an understanding with my doctor that they were harmless, benign episodes. The sensation of a fish flopping around in my chest no longer sent me in a panic attack. (I do suffer from PTSD and severe panic disorder, have had years of therapy to deal with both and take an anti-anxiety med every day)
Fast forward a decade or two and I an now the proud owner of two cardiac stents. I have HYPER-lipodemia, my body produces way too much cholesterol no matter what I do, and that was a huge factor in the clogged arteries. My arteries were so bad, the surgeon told me he couldn't believe I hadn't had a "major event." (Don't you just love they way they skirt around saying "I can't beleive you're not DEAD!) LOL
I have felt, as you can imagine, much better since the stents. (They were placed almost 3 years ago) Until I lost my job and my health insurance, I kept up with very regular check ups with my cardiologist and his nurse who is in charge of helping his patients control their cholesterol through diet, exercise and if needed, medications. I WAS taking 2000mgs of Niaspan until I lost my insurance and have been jumping through the pharmaceutical hoops to get the med a low or no cost. (It cost $400 a month) Still working on that 6 months down the road.
I was due, this past December of 2012, to see my cardio for another stress and echo test. Due to lack of insurance, this didn't happen. This was an important test as a third artery in my heart showed signs of plaque build-up, but not sufficient at that time for the placement of a third stent. That is what this test was going to check for. Need I say that NOT having the test has caused me an increase in anxiety? Didn't think so.
I am feeling fine, have no symptoms like last time, but what has begun to happen in the last 2-3 months is that I believe I am having CVTs. I have NOT been diagnosed with that except by me, so maybe that isn't the right issue.
What happens is that always at night, after I've eaten and am hanging out on the couch, my pulse changes and I can feel it changing. It does NOT speed up or slow down. I do NOT feel dizzy or lightheaded or short of breath or have chest pains or pains in my arm or jaw. I have NO symptoms other than my pulse rate doing weird things. By that I mean my heart will beat very normally for 6 beats and then their is no beat, but the next beat feels rather heavy or hard. (But no pain) Then my heart will beat normally for 4 beats and the another skipped beat, 12 beats and a skip. 3 beats and a skip. 48 beats and a skip. These episodes could last 5 minutes or 15. They did cause me anxiety, which naturally affects my heart rate, but it NEVER went above 80bmp.
I spoke with my cardios triage nurse about them and she reassued me that with no other signs or symptoms of heart attack, they wre totally benign. Scary, yes, but harmless. She said they were probably happening during the day, but I was too busy to take notice. I couldn't seem to make her understand that with my own special brand of HIGH ALERT HEART ANXIETY, there is NO WAY I would not notice this happeing. But, I took a great deal of reassurance from her and for at least the past month, while they still scared me, I just repeated what she told me and I got them.
Last night, again after I had eaten and was snuggling up on the couch with the cats and dogs, they began. I did my best to remain calm and just wait them out, knowing the episode would be over soon. But this time, it didn't stop for at least an hour, and it was different. My heart would beat normally for only 2-3 beats and then skip. A few times it would beat 5 times and skip. But there were no longer long pauses between. I don't remember falling asleep, but I woke up at 3 am. My very first thought was "did I fall alseep or did I pass out?" I was instantly in panic mode and the skips began again. (My husband works nights, so I was alone which just exacerbates my anxiety) I wandered around thinking maybe I should call 911, which just makes me panic more. I took one of my Xanax to deal with the anxiety. Bad enough I'm talking myself into a heart attack, I don't need the extra anxiety to help THAT along. As soon as I took the Xanax, they stopped. I went to bed, no skips, I read for an hour, one or two skips. I turned out the light and here I am, 12 hours later, writing to you. I have been "watching" my heart like a hawk and have felt no skips at all. I feel tired but otherwise fine. I think I am getting a phobia about the evening as being the "hour of the dreaded skipped beats."
There HAS been more than the usual boat load of stress in our lives recently, and I know anxiety can cause all sorts of physical symptoms, I just don't think it can actually alter the number of times your heart beats. I know it can INCREASE the rate, but skipped beats?
Should I just trust the cardio nurse that without any other symptoms these are benign and learn to live with them? Should I call her back and tell her what happened last night? Was that a sign of up and coming doom? Should I sleep in my car next to the ER? Should I see my cardio, which is really out of the question financially? Why would these seem to suddenly begin? Is my anxiety/panic causing them? Is there anything you can do to make them stop? I've read on here that sometimes bearing down can help?
As you can see, I'm quite frightened and some learned insight would go a very long way to help. The reasonable side of me tells me the nurse is right, without any other signs or symptoms, it's just my heart playing a joke, but I'm not laughing.
I also wanted to mention that these do not happen every night. Sometimes weeks, if not longer will pass between episodes.
The other bad thing I did last night was to look up in one of the medical books about CVTs and such and what I was reading about skipped beats was VERY reassuring until I read the bit about "these are generally benign UNLESS there is an underlying problem like CAD!" Well, didn't THAT just pop my little hard won peace of mind! NOT.
I am so very sorry for the length of this post. Panic seems to make me prolific.
Thanking anyone in advance who can make sense of this and offer advice.
Peace
Greenlydia
Fast forward a decade or two and I an now the proud owner of two cardiac stents. I have HYPER-lipodemia, my body produces way too much cholesterol no matter what I do, and that was a huge factor in the clogged arteries. My arteries were so bad, the surgeon told me he couldn't believe I hadn't had a "major event." (Don't you just love they way they skirt around saying "I can't beleive you're not DEAD!) LOL
I have felt, as you can imagine, much better since the stents. (They were placed almost 3 years ago) Until I lost my job and my health insurance, I kept up with very regular check ups with my cardiologist and his nurse who is in charge of helping his patients control their cholesterol through diet, exercise and if needed, medications. I WAS taking 2000mgs of Niaspan until I lost my insurance and have been jumping through the pharmaceutical hoops to get the med a low or no cost. (It cost $400 a month) Still working on that 6 months down the road.
I was due, this past December of 2012, to see my cardio for another stress and echo test. Due to lack of insurance, this didn't happen. This was an important test as a third artery in my heart showed signs of plaque build-up, but not sufficient at that time for the placement of a third stent. That is what this test was going to check for. Need I say that NOT having the test has caused me an increase in anxiety? Didn't think so.
I am feeling fine, have no symptoms like last time, but what has begun to happen in the last 2-3 months is that I believe I am having CVTs. I have NOT been diagnosed with that except by me, so maybe that isn't the right issue.
What happens is that always at night, after I've eaten and am hanging out on the couch, my pulse changes and I can feel it changing. It does NOT speed up or slow down. I do NOT feel dizzy or lightheaded or short of breath or have chest pains or pains in my arm or jaw. I have NO symptoms other than my pulse rate doing weird things. By that I mean my heart will beat very normally for 6 beats and then their is no beat, but the next beat feels rather heavy or hard. (But no pain) Then my heart will beat normally for 4 beats and the another skipped beat, 12 beats and a skip. 3 beats and a skip. 48 beats and a skip. These episodes could last 5 minutes or 15. They did cause me anxiety, which naturally affects my heart rate, but it NEVER went above 80bmp.
I spoke with my cardios triage nurse about them and she reassued me that with no other signs or symptoms of heart attack, they wre totally benign. Scary, yes, but harmless. She said they were probably happening during the day, but I was too busy to take notice. I couldn't seem to make her understand that with my own special brand of HIGH ALERT HEART ANXIETY, there is NO WAY I would not notice this happeing. But, I took a great deal of reassurance from her and for at least the past month, while they still scared me, I just repeated what she told me and I got them.
Last night, again after I had eaten and was snuggling up on the couch with the cats and dogs, they began. I did my best to remain calm and just wait them out, knowing the episode would be over soon. But this time, it didn't stop for at least an hour, and it was different. My heart would beat normally for only 2-3 beats and then skip. A few times it would beat 5 times and skip. But there were no longer long pauses between. I don't remember falling asleep, but I woke up at 3 am. My very first thought was "did I fall alseep or did I pass out?" I was instantly in panic mode and the skips began again. (My husband works nights, so I was alone which just exacerbates my anxiety) I wandered around thinking maybe I should call 911, which just makes me panic more. I took one of my Xanax to deal with the anxiety. Bad enough I'm talking myself into a heart attack, I don't need the extra anxiety to help THAT along. As soon as I took the Xanax, they stopped. I went to bed, no skips, I read for an hour, one or two skips. I turned out the light and here I am, 12 hours later, writing to you. I have been "watching" my heart like a hawk and have felt no skips at all. I feel tired but otherwise fine. I think I am getting a phobia about the evening as being the "hour of the dreaded skipped beats."
There HAS been more than the usual boat load of stress in our lives recently, and I know anxiety can cause all sorts of physical symptoms, I just don't think it can actually alter the number of times your heart beats. I know it can INCREASE the rate, but skipped beats?
Should I just trust the cardio nurse that without any other symptoms these are benign and learn to live with them? Should I call her back and tell her what happened last night? Was that a sign of up and coming doom? Should I sleep in my car next to the ER? Should I see my cardio, which is really out of the question financially? Why would these seem to suddenly begin? Is my anxiety/panic causing them? Is there anything you can do to make them stop? I've read on here that sometimes bearing down can help?
As you can see, I'm quite frightened and some learned insight would go a very long way to help. The reasonable side of me tells me the nurse is right, without any other signs or symptoms, it's just my heart playing a joke, but I'm not laughing.
I also wanted to mention that these do not happen every night. Sometimes weeks, if not longer will pass between episodes.
The other bad thing I did last night was to look up in one of the medical books about CVTs and such and what I was reading about skipped beats was VERY reassuring until I read the bit about "these are generally benign UNLESS there is an underlying problem like CAD!" Well, didn't THAT just pop my little hard won peace of mind! NOT.
I am so very sorry for the length of this post. Panic seems to make me prolific.
Thanking anyone in advance who can make sense of this and offer advice.
Peace
Greenlydia
Best Answer
" I am convinced that when my heart rate gets slow, I get more ectopic beats"
You do! You absolutely do, and there is a reason for this, related to the natural interval between heartbeats. For those of us with "twitchy" or more excitable heart cells, a prolonged interval gives these naughty cells more of a chance to fire early.
For those who are essentially healthy, there is no medical significance. It is very much like a hiccup, and the heart can handle it just fine. But the sensation IS disturbing.
You do! You absolutely do, and there is a reason for this, related to the natural interval between heartbeats. For those of us with "twitchy" or more excitable heart cells, a prolonged interval gives these naughty cells more of a chance to fire early.
For those who are essentially healthy, there is no medical significance. It is very much like a hiccup, and the heart can handle it just fine. But the sensation IS disturbing.
Many times when I am relaxing at night my heart goes wacky. Same thing, I will get up and walk around and it stops or gets better. I also take my beta blocker in the evening after dinner. I am convinced that when my heart rate gets slow, I get more ectopic beats. Lots of people on this board have noticed the same. And I think when you are just sitting around and aren't busy you pay more attention to them.
I also wanted to say, my husband has had a MI and quadruple bypass. In Jan we were in the ER because he had gone into Afib. After he converted to normal sinus rhythm I noticed a lot of PVCs on the monitor and said something to the cardiologists. He totally blew them off, was not at all concerned.
It sounds like what you are experiencing is pretty run of the mill PVCs or PACs. I wouldn't become overly alarmed about it and quit dwelling on them. Don't let them take over your life, they are monsters. If you could somehow manage a doctors visit it would probably relieve lots of your stress.
Take care.
I also wanted to say, my husband has had a MI and quadruple bypass. In Jan we were in the ER because he had gone into Afib. After he converted to normal sinus rhythm I noticed a lot of PVCs on the monitor and said something to the cardiologists. He totally blew them off, was not at all concerned.
It sounds like what you are experiencing is pretty run of the mill PVCs or PACs. I wouldn't become overly alarmed about it and quit dwelling on them. Don't let them take over your life, they are monsters. If you could somehow manage a doctors visit it would probably relieve lots of your stress.
Take care.
Thank you so very much for your response. It went a long way to calm me down.
There is really nothing more I would like to do than sit down with my cardilogist and discuss this, but financially, it's just out of the question. I could see him as long as I had the cash to pay for the consult, but as you probably know, those consults do NOT come cheap.
You said one thing that I would appreciate you clarifying for me. You stated, "since you are tolerating them well with them being isolated as opposed to coming in runs you may be in no less danger than someone without heart disease."
What do you mean by being "isolated as opposed to coming in runs?"
Yesterday was beautiful here and I puttered around outside all day. I was being extremely vigilant about what my heart was up to. Twice I believe I had what I have always considered a "palp." A quick sensation of something flopping about in my chest, then gone. I had no prolonged out of whack heart beats.
That night, after dinner, on the couch, I was very relaxed, also very tired and sore. LOL Then it began. I did my very best to ignore them and just focus on my movie, but my anxiety kicked in and that, as they say, was that. I "tolerated" them for almost an hour but by this time, my anxiety was such that I couldn't even sit still.
Funny, but even though I was scared, the more defining emotion I had was anger. Anger that these "things" were buggering up my peacefull evening. I got up and because of the layout of my house, I am able to walk from the living room, into the kitchen, into the dining room, down a short hallway and back into the living room. Bit of a loop, eh? Anyway, I began to walk around and around that loop very fast paced and I noticed by the end of my second loop, THEY had completely stopped! I kept expecting them to return at any moment, so I kept up my walk-about for at least 30 loops and then sat back down on the couch. Never had another one the entire night!
So, what's up with THAT?
When you said that eating was a big trigger for you, I just sat here being amazed that food, any kind of food, could possibly cause the heart to beat in what I'm going to call "the wrong way." I am NOT doubting what you're saying, but if you could help me understand how this happens, I would grateful.
I HAVE been diagnosed with acid reflux and when I've had these symptoms before, after some small amount of research, I thought they might possibly be esophageal spasms. But those would not, to the best of my knowledge, cause your heart to skip or add beats. Am I wrong?
I have no doubt that I'm having more of these because I am now much more stressed about them. The episode last night pretty much convinced me of that.
I am, and have always been, a stress monster. Please don't suggest therapy as I have PTSD and have spent many a year talking with p-docs who are aware of my aniety/panic/stress trifecta of lousy mental health. They managed to put Humpty-Dumpty most of the way back together, but they all agreed there would always be some small cracks here and there.
Neither my cardiologist nor my thoracic surgeon ever said to me that my heart was damaged. It has been my understanding these past years since I've had the stents that I was most assuradley heading toward damaging my heart by having a pesky MI, but they caught and stopped that in time. While I believe I have heart disease due to the hyperlipedemia which lead to my needing the stents, I believe, and I hope I'm not wrong about this, that my heart muscle itself is basically OK, undamaged, but that I have to be very diligent about keeping my cholesterol in check, and keeping on top of regular cardio check ups.
I take Norvasc and Atenolol and an 81mg aspirin, my BP is good, and I have no restrictions on activity.
While your suggestion of having an EKG is a good one, my only problem with finding any peace in that procedure is that an EKG will only tell the doctor what your heart is doing at the moment of the test. 5 minutes post test, I could keel over with a massive heart attack. I'd rather trust what a Holter would tell us, but since these episodes don't happen everyday, it would be my luck that even if I wore the Holter for 48 hours, my heart beat would do nothing odd that entire time!
One last question before you kick me out of here for being a pain in your butt...............a few times last night when I was having this episode, I felt like I had "lost my breath," which doesn't really describe the feeling adequately. I did not EVER feel short of breath, more like there was a very quick "catch" in my breathing. Do you have any idea what I'm talking about?
I am in contact with my cardio's office, and we are working on a way to get me in there for an exam and any tests the doc wants to run, but it's unfortunately not up to them, it's up to the bean counters and they don't care.
You have given me a great deal of peace of mind and I can't thank you enough.
What I want to know is can I call you at 3 am when I'm next freaking out? ROFLMAO
Peace
Greenlydia
There is really nothing more I would like to do than sit down with my cardilogist and discuss this, but financially, it's just out of the question. I could see him as long as I had the cash to pay for the consult, but as you probably know, those consults do NOT come cheap.
You said one thing that I would appreciate you clarifying for me. You stated, "since you are tolerating them well with them being isolated as opposed to coming in runs you may be in no less danger than someone without heart disease."
What do you mean by being "isolated as opposed to coming in runs?"
Yesterday was beautiful here and I puttered around outside all day. I was being extremely vigilant about what my heart was up to. Twice I believe I had what I have always considered a "palp." A quick sensation of something flopping about in my chest, then gone. I had no prolonged out of whack heart beats.
That night, after dinner, on the couch, I was very relaxed, also very tired and sore. LOL Then it began. I did my very best to ignore them and just focus on my movie, but my anxiety kicked in and that, as they say, was that. I "tolerated" them for almost an hour but by this time, my anxiety was such that I couldn't even sit still.
Funny, but even though I was scared, the more defining emotion I had was anger. Anger that these "things" were buggering up my peacefull evening. I got up and because of the layout of my house, I am able to walk from the living room, into the kitchen, into the dining room, down a short hallway and back into the living room. Bit of a loop, eh? Anyway, I began to walk around and around that loop very fast paced and I noticed by the end of my second loop, THEY had completely stopped! I kept expecting them to return at any moment, so I kept up my walk-about for at least 30 loops and then sat back down on the couch. Never had another one the entire night!
So, what's up with THAT?
When you said that eating was a big trigger for you, I just sat here being amazed that food, any kind of food, could possibly cause the heart to beat in what I'm going to call "the wrong way." I am NOT doubting what you're saying, but if you could help me understand how this happens, I would grateful.
I HAVE been diagnosed with acid reflux and when I've had these symptoms before, after some small amount of research, I thought they might possibly be esophageal spasms. But those would not, to the best of my knowledge, cause your heart to skip or add beats. Am I wrong?
I have no doubt that I'm having more of these because I am now much more stressed about them. The episode last night pretty much convinced me of that.
I am, and have always been, a stress monster. Please don't suggest therapy as I have PTSD and have spent many a year talking with p-docs who are aware of my aniety/panic/stress trifecta of lousy mental health. They managed to put Humpty-Dumpty most of the way back together, but they all agreed there would always be some small cracks here and there.
Neither my cardiologist nor my thoracic surgeon ever said to me that my heart was damaged. It has been my understanding these past years since I've had the stents that I was most assuradley heading toward damaging my heart by having a pesky MI, but they caught and stopped that in time. While I believe I have heart disease due to the hyperlipedemia which lead to my needing the stents, I believe, and I hope I'm not wrong about this, that my heart muscle itself is basically OK, undamaged, but that I have to be very diligent about keeping my cholesterol in check, and keeping on top of regular cardio check ups.
I take Norvasc and Atenolol and an 81mg aspirin, my BP is good, and I have no restrictions on activity.
While your suggestion of having an EKG is a good one, my only problem with finding any peace in that procedure is that an EKG will only tell the doctor what your heart is doing at the moment of the test. 5 minutes post test, I could keel over with a massive heart attack. I'd rather trust what a Holter would tell us, but since these episodes don't happen everyday, it would be my luck that even if I wore the Holter for 48 hours, my heart beat would do nothing odd that entire time!
One last question before you kick me out of here for being a pain in your butt...............a few times last night when I was having this episode, I felt like I had "lost my breath," which doesn't really describe the feeling adequately. I did not EVER feel short of breath, more like there was a very quick "catch" in my breathing. Do you have any idea what I'm talking about?
I am in contact with my cardio's office, and we are working on a way to get me in there for an exam and any tests the doc wants to run, but it's unfortunately not up to them, it's up to the bean counters and they don't care.
You have given me a great deal of peace of mind and I can't thank you enough.
What I want to know is can I call you at 3 am when I'm next freaking out? ROFLMAO
Peace
Greenlydia
It sounds like you are having ectopic beats, pacs or pvcs. The hard ones are likely pvcs the less obvious ones may be pacs though not everyone feels their pvcs or pacs so it is hard to say exactly what you have without it being recorded. The general consensus is if the heart is structurally normal then the extra beats are of no concern. You have clogged arteries but if your heart has not been damaged by the clogged arteries then you are likely fine. Of course no one but a doctor can give you a clean bill of health, I would say not even the nurse. Considering you do have a history of problems it may be good to speak with your doctor. An echo would likely be in order but that said, since you are tolerating them well with them being isolated as opposed to coming in runs you may be in no less danger than someone without heart disease. But you may want to at least consult with your cardiologist to get his opinion on your risks just to be sure.
I will say eating is a big trigger for me. Especially after meals high in carbohydrates. So watch what you eat and tackle any acid reflux you might have. As well stress is a huge trigger. The more you stress about having them the more of them you will have so whatever you can do to calm yourself once you feel them will help them go away faster. For me sometimes if I start to get a lot coughing can help stop them though too much coughing can bring them on. But basically whatever you are feeling you may have had these for a long time but just didn't feel them. The flip flopping may have partly been them as well, maybe pacs so it could very well be that they are better than they use to be for you since you had your heart cleaned out a bit. Anyways, I would suggest at least making an appointment to consult with the doctor even if you can't afford the big tests talking with him and doing a simple ekg will give a pretty good evaluation if the heart is in stress. Then just do what you can to find and eliminate your triggers as well do your best to ignore them if you can. Well hang in there and stay strong. Do you best to try and not let these things rob you of your peace of mind. Take care.
I will say eating is a big trigger for me. Especially after meals high in carbohydrates. So watch what you eat and tackle any acid reflux you might have. As well stress is a huge trigger. The more you stress about having them the more of them you will have so whatever you can do to calm yourself once you feel them will help them go away faster. For me sometimes if I start to get a lot coughing can help stop them though too much coughing can bring them on. But basically whatever you are feeling you may have had these for a long time but just didn't feel them. The flip flopping may have partly been them as well, maybe pacs so it could very well be that they are better than they use to be for you since you had your heart cleaned out a bit. Anyways, I would suggest at least making an appointment to consult with the doctor even if you can't afford the big tests talking with him and doing a simple ekg will give a pretty good evaluation if the heart is in stress. Then just do what you can to find and eliminate your triggers as well do your best to ignore them if you can. Well hang in there and stay strong. Do you best to try and not let these things rob you of your peace of mind. Take care.
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By isolated I mean they are not coming in runs which for pacs would be considered and svt or for pvcs would be considered vt. VT can be dangerous in an unhealthy heart because there is a chance it could degenerate into vfib which can be fatal if not treated within a few minutes. However a lot of people with VT convert on their own and it doesn't last long. If it does they can put in an Internal Cardiac Defibrillator. But the fact that your heart is not damaged, they caught this issue before you had an MI does give you much better odds that the heart can tolerate the extra beats without issue the same as others who do not have CAD. Considering you have CAD you may be at a bit of a higher risk than I who doesn't but your heart muscle being healthy does bode very well for you. So just try to trust in that. Your heart is a very resilient muscle. And you have done it a great favor by catching your CAD before it damaged the heart.
As for eating causing the extra beats, from my understanding the vagus nerve is connected to the stomach as well as the heart. When we irritated that nerve with acid reflux and such the vagus nerve sends signals back to the heart causing it to act up. As well I do believe sugars and carbohydrates do some sort of molecular change that affects the heart as well. As well bloating from a heavy meal can put pressure on the chest cavity which can spur the heart into action. So eating can inadvertently cause the ectopics to act up. Once the food is digested enough the ectopics will generally stop.
The ectopics for me tend to jump in the slower my heart rate. So getting up and moving around like you did pacing the room very well raised your heart rate and got the extra beats to stop. It may have also helped to calm your nerves which may have helped them to stop as well.
As for why they sometimes catch your breath this likely has to do with when in the beat cycle they jump in. If you throw one right at the time you are about to breath it can throw that process off as well there is a blood flow factor if there is too much or too little when the cycle gets interrupted it can affect how strongly the next beat feels if there is more blood in the heart than with a normal beat. I am not a doctor so I am not totally sure about the exact science behind it all but that is my understanding of it. You may be able to do some research online to get a better understanding but for the most part they feel different depending on when in the beat cycle they hit.
I suggested the EKG because though it can't tell you that you have ectopic beats unless it is happens right when you have the test taken an EKG can tell the doctor if anything serious like an MI has happened. The way the heart beat looks on the strip can tell not only if something happened but to some degree where in the heart it may have happened so it isn't just a test to find an irregular beat. It is actually a test to see the health of the heart in how the heart is beating. You are right to catch the ectopics a holter is the recommended method. The holter would tell the doctor how many you are having a day. This is probably the most important factor in the seriousness of the ectopics.
The fact you say you don't have them every day is another good sign for you that this isn't a bigger issue. The going theory is that so long as you aren't having more than 20,000 of these a day, or 20% of your heart beats being ectopics they are considered benign in a healthy heart. I do believe they are now leaning towards them even being benign in an unhealthy heart or in the minimum, in people like you, who have heart disease but still your heart muscle is healthy and strong. But the point being even at 20,000 a day though there is a chance of heart failure due to the high load it doesn't mean a person is guaranteed to have issues, especially if they are isolated and not in runs. But you sound like you don't have nearly that many and not having them every day is also a very good sign. More than likely your doctor will tell you to ignore them but it really is best to let him know so you can be evaluated against your healthy history.
Well best of luck with the doctor. I know most are will to try and work out a payment plan for those with financial issues. I do hope yours has that kind of compassion. And please do stop by anytime you need to talk. There are a lot of people on here who are dealing with ectopics and who get just as stressed about them as you do. I don't know that I stress about them but they can for sure be distracting and cause a person to hyper focus on the heart. But for the most part I really do try my best to ignore them and not allow them to rule my life. I have come to accept that my heart will probably always act up from time to time. It isn't something I can truly control but I can control how I choose to react to what it is doing. So just do your best to maybe even get angry enough that you refuse to let these silly extra beats run your life. It is the one thing you can control. Take care and stay strong.