Heart trouble

("RomeoMike" wrote)
This isn't amateur night on a medical newsgroup.


How do you to get to Carnegie Hall?

From the Carnegie Hall website:
"While it takes some [Doctors] a lifetime of practice to get to Carnegie
Hall (as the saying goes), others just have to follow these simple
directions."


Paul-Mont :-)

RomeoMike wrote:



Whoa! Where's all this medical advice coming from? Also, it's quite
possible that tests other than an INR were ordered, requiring a
venipuncture as opposed to a finger stick. No point in making the guy
lose confidence in his facility without more reason.




Its highly unlikely that any other lab testing is being done on an
outpatient basis AT THIS POINT other than an INR. Thats my opinion based
on 18 years in the emergency and critical care fields of healthcare.

Also, for what its worth, I have not heard of any of the hospitals or
outpatient labs in the greater Houston area doing fingerstick INR's, nor
have I had a patient indicate or ask why we arent "pricking their
finger, like at the lab". 4th largest population center in the US, and
I've worked all over it.

Up to this point, I've agreed with everything Tina has said. Its pretty
much on the mark. Afib, when properly anticoagulated, has minimal risk
of sudden incapacitation. This may not be as big of a hindrance as CJ is
worried about.

Dave, RN

RomeoMike wrote:
.. This isn't amateur night on a medical
newsgroup.

Cheers

Im not an amatuer. Shes correct.

Hilton wrote:
That's pretty funny. After reading your first line, my head went into
overdrive thinking how a-fib's side effects could cause earache.

Hope it all works out CJ.

Hilton


This.. is a good example of whats caused an "incidental finding"

Dave

Have to agree with Tina- as a matter of my daily practice, I put hundreds of
people on coumadin every year. It does require careful monitoring,
particularly when first started.

Chemical (via drugs) and electrical (cardioversion) are still used to
convert new onset a-fib. There is probably a bigger risk from the chronic
coumadin usage than the underlying a-fib.

Allen wrote:.
When I was a kid on the farm Warfarin was in the bait we set out for the
rats (not that I am implying anything here). Sorry to hear this CJ.

Check out Aviatrix's blog (particularly the archives from 3-6 months
ago) for similar comments and one pilot's experience with Warfarin.
Take her account with a grain of salt, however, as she's Canadian, and
their medical standards are apparently far more strict than in the US.

http://airplanepilot.blogspot.com/

-Doug

--
--------------------
Doug Vetter, ATP/CFI

http://www.dvatp.com
--------------------

On 2007-07-13 18:22:45 -0700, Dave S said:

Hilton wrote:
That's pretty funny. After reading your first line, my head went into
overdrive thinking how a-fib's side effects could cause earache.

Hope it all works out CJ.

Hilton


This.. is a good example of whats caused an "incidental finding"

Dave

Well, you know -- it was not just the earache. I had been having this
earache off and on for a few weeks. And I was dizzy, like with an ear
infection. But I was too busy to do much about it and figured it would
go away.

So, I suppose the earache was from the wax buildup. The dizziness might
have been caused by the a-fib.
--
Waddling Eagle
World Famous Flight Instructor

C J Campbell wrote:

So, I suppose the earache was from the wax buildup. The dizziness might
have been caused by the a-fib.

More than likely was - the dizziness, that is.

From a pumping standpoint, your ventricles do the majority of the
pumping work. After a heartbeat, they relax and passively refill while
waiting for the next beat.(remember this occurs 60-80 times a minute in
a healthy person at rest). In healthy people, this passive refilling
accounts for about 70% of the amount of blood that will be pumped on the
next beat/contraction.

The atria contribute an additional 30% or so by actively contracting,
and filling the ventricles fully just immediately before the ventricles
contract.

This atrial kick therefore accounts for about 30% of your cardiac
output. In individuals without a large "reserve" in cardiac ability,
this 30% can make the difference between something like a-fib being an
annoyance or a true problem. As a general rule, the unhealthier someone
is from a cardiovascular standpoint, the less able they are to tolerate
this problem.

Your dizziness does not mean you tolerated it poorly, per se, but it was
likely a symptom, and it could be fair to say you were "symptomatic"

Some examples of very poorly tolerating it would be passing out,
having chest pain, poor exercise tolerance to the point you cant even
walk from the bed to the bathroom without stopping to get your breath.

CJ

Welcome to the crowd.

I have A-FIB. Had abulation (burning) and also cutting the nerves in
upper chamber with a knife. Both were done through an arterie and not
open heart surgery.

Bad news is that neither procedure fixed my A-fib and have been living
with it for 7-8 years.

Have gone through 3 pacemakers and latest 2 months ago is like
Cheney's with a defib in it. Current one also three leads from it to
upper and lower chambers of heart.

I asked my surgeon how long I would live and he said until I die (
Didn't think that was a very good answer for what he got to put the
pacemaker in.

Prior pacemaker only had two leads and it fired the upper chamber and
then the lower chamber which was supposed to give normal blood flow. I
didn't feel any problems with it but they said I had a lazy heart and
needed a new one with defib????????

I'm not restricted from driving but am sure would not pass the
physical for my commercial/instructor ticket.

I am on coumadin (blood thinner) and just touch something and bleed.
Have scars from this on both arms. If I'm doing any work I wear rubber
gloves to prevent fingers and hands from bleeding.

If I can answer any questions let me know. You can go off line to my
e-mail address at top of this post.

Good luck.

Big John
************************************************** *****

On Fri, 13 Jul 2007 07:36:28 -0700, C J Campbell
wrote:

It appears that I am having a little bit of trouble with my heart. It
came on rather suddenly, as an EKG last December showed no problem at
all. But apparently I have developed something called an atrial
fibrillation. It doesn't look good for my flying status, but we shall
see.

CJ

Warfarin is the name brand and more expensive. Coumadin is the generic
and much cheaper if you are paying out of pocket. Also most HMO's only
pay for the generic. Both seem to work OK.

Big John
************************************

On Fri, 13 Jul 2007 09:11:39 -0700, C J Campbell
wrote:

On 2007-07-13 07:46:03 -0700, Tina said:

Re a-fib, very very common. May not screw up your medical, There are
meds that work to control it, but ablation seems like a sure cure for
many. If it's serious you MUST get onto an aggressive anticoagulant,
check with your MD. Coumadin is most often used.


You'll be told a-fib is not life threatening, that no one dies of it.
That's true, BUT that turbulant blood flow can cause clots, and those
can cause strokes, that's why an anti coagulant is needed.

Hah! Not exactly comforting. I got extremely small veins, you know. It
takes 'em four or five tries to get a blood test. :-)

They gave me Warfarin, which is a coumadin derivative.

I think that is the main thing -- making sure that:
a) Whatever caused it is not life threatening, it coming on so suddenly and
b) Whatever medication they give me doesn't ground me.